内镜下乳头括约肌小切开联合球囊扩张与常规乳头括约肌切开治疗胆总管结石的比较研究

Comparison of small endoscopic sphincterotomy plus endoscopic papillary balloon dilatation with conventional endoscopic sphincterotomy for removal of bile duct stones

目的比较应用十二指肠乳头括约肌小切开加球囊扩张(SEST+EPBD)与常规十二指肠乳头括约肌切开(EST)对胆总管结石治疗效果及安全性探讨。方法回顾性分析2010年1月至2012年8月间74例胆总管结石患者的临床资料,其中29例行十二指肠乳头括约肌小切开加球囊扩张,45例行常规十二指肠乳头括约肌切开,比较2种术式的取石成功率及术后并发症情况。结果 SEST+EPBD组与常规EST组一次性取净结石成功率分别为93.10%和93.33%(P>0.05);SEST+EPBD组与常规EST组术后并发症中,出血发生率分别为0%和6.67%(P>0.05),胰腺炎的发生率分别为3.45%和4.44%(P>0.05)。2组均无穿孔并发症,无死亡病例。结论 SEST+EPBD术取石成功率和术后并发症的发生率与常规EST相当,是一种安全有效的胆总管结石的内镜治疗方式。

Objective To compare the therapeutic effect of small endoscopic sphineterotomy（SEST） plus endoscopic papillary balloon dilatation（EPBD） with that of conventional EST for removal of bile duct stones and to explore the security. Methods A retrospective review of 74 patients with bile duct stones in our hospital from Jan. 2010 to Aug. 2012 was conducted. Twenty - nine of the 74 patients received SEST plus EPBD and the other 45 received EST, and the rates of successful stone removal and complications were compared. Results The rate of successful stone removal in SEST ＋ EPBD and EST group was 93.10% and 93.33%, respectively. The comphcation of hemorrhage in SEST ＋ EPBD and EST group was 0% and 6.67%, respectively; the occurrence rate of pancreatitis was 3.45% and 4.44%, respectively. No perforation and death occurred in both groups. Conclusion The rates of successful stone removal and complications of are similar between the 2 groups. SEST plus EPBD is a safe and effective treatment for endoscopic removal of common bile duct stones.