乏特氏壶腹嵌顿结石的内镜处理

ENDOSCOPIC MANAGEMENT OF CALCULOUS OBSTRUCTION IN VATER’S AMPULLA

本文就９４例因乏特氏壶腹嵌顿结石所致的急腹症实施内镜乳头括约肌切开术（ＥＳＴ），并同时取出嵌顿的结石，或将较大结石松动后送回胆总管内并置入支撑引流导管达到迅速解除梗阻，胆胰管减压，通畅引流的治疗目的进行了，总结。结果８３例（８８．３％）治愈；１１例（１１．７％）平稳渡过急性期后择期手术；２例（２．１％）术后出现并发症，经对症治疗后痊愈。本文仅对ＥＳＴ的优点；乳头括约肌的切开长度；取石时机等问题进行了探讨。

he article is related to the endoscopic management of acute abdomen caused by calculous obstruction atampulla of Vateron. Ninty-four cases were performed EST(Endoscopic Sphincterotomy), and calculi werepicked out or pushed back to the common bile duct simutaneously. Endoscopic nasobiliary drainage(ENBD)was used when necessary.The result showed 83 cases(88.3%)were cured, 11 cases(11.7%)provided a suit-able condition for later operation,in which 2 cases(2.1%)coped with complications and cured with respectivemedication. In general, the obstruction can be relieved promptly,the pancreato-biliary duct decompressedquickly and bile drained smoothly through this endoscopic route,The advantage of EST,the length of incisionin EST and the opportunity of removing of the calculi were also discussed in this article.