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内镜下十二指肠乳头柱状气囊扩张治疗胆总管结石

Endoscopic papillary balloon dilation in the treatment of common bile duct stones

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【作者】 李能平杨味香刘江奇杨志强耿志坚周鸣清陆仁达

【Author】 Li Nengping, Yang Weixiang, Liu Jiangqi, et al. Department of Surgery, Shanghai Gongli Hospital, Shanghai 200135, China

【机构】 上海市浦东新区公利医院外科上海市闸北区中心医院外科上海市闸北区中心医院外科 上海200135上海200135上海200070上海200070

【摘要】 目的 探讨内镜下十二指肠乳头柱状气囊扩张 (Endoscopicpalillaryballoondilatation ,EPBD)治疗胆总管结石的指征和临床效果。 方法  1999年 4月~ 2 0 0 1年 8月 ,对 4 2例胆总管结石采用EPBD、网篮或取石气囊取石等方法进行治疗。柱状气囊长 5cm ,最大扩张直径 1 2cm。胆总管结石数目少于 3枚、结石最大直径≤ 1 0cm。施加压力 (8~ 12 )个大气压 ,对应的扩张直径为 1 0cm~ 1 2cm ,每次扩张持续 2分钟 ,扩张 2次。 结果  4 2例均获成功 ,36例一次性取尽结石 ,4例改行EST后取石成功 ,取石总成功率为 95 2 % (40 4 2 )。 2例取石失败。 3例术后有轻症胰腺炎 ,无肠穿孔、出血等并发症。 结论 当胆总管结石直径≤ 1 0cm ,数目 <3枚 ,特别是十二指肠乳头位于憩室内 ,可采用EPBD治疗。

【Abstract】 Objective To explore the indications and efficacy of endoscopic papillary balloon dilation(EPBD) in the management of choledocholithiasis. Methods EPBD combined with a retrieval basket or balloon or both was performed to remove common bile duct stones in 42 cases from April 1999 to August 2001. The length and maximum diameter of the balloon were 5 0cm and 1 2cm respectively. The number of common bile duct stones must be less than 3, and the diameter must be less than or equal to 1 0cm. The balloon was inflated at pressure of (8~12)atm for 2min two times and the corresponding dilated diameter was 1 0cm~1 2cm. Results EPBD was performed successfully in all patients. The common bile duct stones were removed in 40 out of 42 patients, including endoscopic sphincterotomy(EST) in 4 patients, with the success rate being 95 2%(40/42). Stone removal failed in 2 patients. 3 cases had mild pancreatitis postoperatively. No complications such as bleeding or intestinal perforation occurred. Conclusions It is suitable to treat common bile duct stones by EPBD when the number of stones is less than 3 and the diameter is less than or equal to 1.0cm.

  • 【文献出处】 中国微创外科杂志 ,Chinese Journal of Minimally Invasive Surgery , 编辑部邮箱 ,2003年01期
  • 【分类号】R657.4
  • 【被引频次】16
  • 【下载频次】53
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