数字胆道镜辅助无射线内镜逆行胰胆管造影术治疗胆管结石的有效性及安全性研究
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东南大学附属中大医院

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Efficacy and safety of digital cholangioscopy‑assisted non‑radiation endoscopic retrograde cholangiopancreatography for common bile duct stones
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    摘要:

    目的 探讨数字胆道镜辅助无射线内镜逆行胰胆管造影术(endoscopic retrograde cholangiopancreatography, ERCP)治疗胆管结石的有效性和安全性。方法 回顾性收集2019年5月—2021年9月在东南大学附属中大医院采用数字胆道镜辅助无射线ERCP治疗胆管结石患者的临床资料,分析患者基线资料、插管成功率、一次取石成功率、操作时间、总住院时间和手术并发症,随访胆管结石复发情况。结果 共纳入170例患者,术前影像学检查中有156例(91.8%)患者检出胆管结石,结石长径为(7.7±4.1)mm。所有患者在胆道镜探查时发现胆管结石,并成功完成数字胆道镜辅助无射线ERCP取石治疗,插管成功率100.0%(170/170)。一次取石成功率为96.5%(164/170),6例(3.5%)患者因巨大结石(长径>30 mm)行分次取石治疗。胆道镜探查时间(9.6±2.7)min(6~24 min),手术时间(35.9±17.3)min(13~85min),总住院时间(6.3±2.2)d(5~10 d)。术后3例(1.8%)患者出现术后胰腺炎,均为轻症,予对症治疗后缓解。患者术后1个月随访均未见胆管结石复发。结论 数字胆道镜辅助无射线ERCP治疗胆管结石安全有效,可避免辐射,值得进一步推广。

    Abstract:

    Objective To evaluate the efficacy and safety of digital cholangioscopy-assisted non-radiation endoscopic retrograde cholangiopancreatography (ERCP) for common bile duct stones. Methods Clinical data of patients who underwent digital cholangioscopy-assisted non-radiation ERCP for common bile duct stones from May 2019 to September 2021 were reviewed. The baseline data, the success rate of cannulation, the one-time success rate of endoscopic stone removal, the operation time, total hospital stay, complications, and recurrence of bile duct stones were analyzed. Results A total of 170 patients were included, and bile duct stones were detected in 156 (91.8%) patients with the long diameter of 7.7±4.1 mm under preoperative imaging examination. Bile duct stones were detected under choledochoscopy and were successfully removed by using digital cholangioscopy through non-radiation ERCP. The success rate of cannulation was 100.0% (170/170) . The one-time success rate of endoscopic stone removal was 96.5% (164/170), and 6 patients (3.5%) received secondary stone removal for large stones (long diameter>30 mm).The time of biliary exploration and whole non-radiation ERCP were 9.6±2.7 min (6-24 min) and 35.9±17.3 min (13-85 min), respectively. The total hospital stay was 6.3±2.2 days (5-10 days). Postoperative pancreatitis occurred in 3 patients (1.8%), all of whom were mild and resolved after symptomatic treatment. No recurrence of bile duct stones was seen in any patient over 1-month postoperative follow-up. Conclusion Digital cholangioscopy-assisted non-radiation ERCP is safe and effective for common bile duct stones without ray exposure, which is worth of promotion.

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张胤秋,冯亚东.数字胆道镜辅助无射线内镜逆行胰胆管造影术治疗胆管结石的有效性及安全性研究[J].中华消化内镜杂志,2023,40(9):702-706.

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  • 收稿日期:2022-11-05
  • 最后修改日期:2023-08-31
  • 录用日期:2023-01-16
  • 在线发布日期: 2023-09-01
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