十二指肠乳头括约肌切开术治疗胆胰疾病

Value of Endoscopic papillo-sphincterotomy in the management of cholangiopancreatic diseases

目的 :探讨十二指肠乳头括约肌切开术(EST)在治疗胆胰疾病中的作用。方法 :回顾性总结1987年7月至1999年10月间实施的712例次EST。结果 :EST治疗缩窄性乳头炎278例 ,成功率97.0 %;继发性胆总管结石559例 ,结石排出率97.1 %;因缩窄性乳头炎所致的慢性阻塞性胰腺炎45例 ,症状缓解率86.7 %;Oddi扩约肌功能障碍12例 ,成功率91.7 %。EST后重症胰腺炎、胆管炎、切口出血等并发症发生率为1.4 %,本组无死亡病例。结论 :EST是理想的治疗部分胆胰疾病的微创外科技术。

Objective:To investigate the value of Endoscopic papillo sphincterotomy (EST) in the management of cholangiopancreatic diseases. Methods: 712 cases treated with EST from July, 1987 to October, 1999 were reviewed. A retrospective analysis of therapeutic effect was made. Results:The rates of success of EST in management of constrictive papillitis and functional disturbance of Oddi's sphincter were 97.0%(278/288) and 91.7%(11/12) respectively. Symptoms of 86.7%(39/45) patients with chronic obstructive pancreatitis caused by constrictive papillitis were alleviated and common bile duct stone was removed in 543 out of 559 patients (97.1%) after EST. The incidence of complications (severe pancreatitis, cholangiotitis and hemorrage) following EST was 1.4%. No patient died in our group. Conclusion:EST is an ideal and mini traumatic treatment for some cholangiopancreatic diseases.