内镜乳头气囊扩张术对胆管结石患者的疗效观察

Efficacy of endoscopic papillary balloon dilatation for bile duct stones

目的评价内镜乳头气囊扩张术（endoscopic papillary balloon dilatation，EPBD）对胆管结石患者的疗效。方法对2000年1月至12月406例接受ERCP治疗的胆管结石患者，按人院时间分两组，EST组205例，EPBD组201例，ERCP时分别行EST和EPBD取石。观察两组在早期并发症、结石清除率、远期并发症等方面的差异。结果两组的早期并发症发生率、结石清除率、胰腺炎发生率比较，差异无统计学意义（X^2=0．540，0．058，0．010，P〉0．05）。EST组的胆囊炎发生率和结石复发率高于EPBD组（X^2=4．002，4．263，P〈0．05）。结论行EPBD治疗胆囊炎发生率和结石复发率明显低于EST，对Oddi括约肌的保护作用也明显优于EST。

Objective To assess the efficacy of endoscopic papillary balloon dilatation （EPBD） for bile duct stones. Methods Four hundred and six patients with bile duct stones who had been treated by ERCP from January 2000 to December 2000 were divided into EST group （ n = 205 ） and EPBD group （ n = 201 ） according to the admission time. The differences upon incidences of early and long-term complications, clearance rate of bile duct stones between the 2 groups were detected. Results There was no significant difference upon the incidence of early complications, clearance rate of bile duct stones and incidence of pancreatitis between the 2 groups （ X^2 = 0. 540, 0. 058, 0.010, P〉0.05）. The incidence of cholecystitis and recurrence rate of bile duct stones in EST group were significantly higher than those in EPBD group （ X^2 = 4. 002, 4. 263, P〈0.05）. Conclusions The incidence of cholecystitis and recurrence rate of bile duct stones after patients being treated by EPBD are signifi- cantly lower than EST. EPBD is superior to EST in protecting the sphincter of Oddi.