内镜下鼻胆管引流术在三镜联合模式治疗胆总管结石中的作用

The role of ENBD in the treatment mode of EST+LC/LCBDE

目的:探讨内镜鼻胆管引流(ENBD)在三镜联合模式(EST加LC/LCBDE)治疗胆总管结石中的作用。方法:将93例胆总管结石患者随机分为试验组和对照组。试验组接受常规留置ENBD的EST加LC/LCBDE模式治疗,对照组接受不留置ENBD的EST加LC模式治疗。结果:两组在一般资料上比较差异无统计学意义(P>0.05)。试验组术后3 h、12 h、24 h和48 h血清淀粉酶水平均低于对照组(P<0.05)。试验组术中结石及时发现率高于对照组(5.88%vs 0%,P<0.05)。试验组治疗后结石残留率低于对照组(0%vs 9.52%,P<0.05),两组均无胆漏发生。结论:常规留置ENBD提高了EST加LC/LCBDE模式治疗胆总管结石的疗效和安全性。

Objective To investigate the role of endoscopic nasobiliary drainage （ENBD） of bile duct in the treatment mode of endo- scopic sphincterotomy （EST） ＋ laparoscopic cholecystectomy （LC）/laparoscopic common bile duct exploration （LCBDE）. Methods 93 patients of CBD stones were enrolled into two groups randomly：trial group （EST ＋ LC/LCBDE with ENBD） and control group （EST ＋ LC without ENBD）. Results No significant differences were observed in Baseline characteristics of the patients between two groups （P 〉 0. 05）. The mean concentrations of serum amylase at the time points （3,1 2,24 or 48 hours after EST） were significantly lower in the trial group than in the control group （P 〈 0. 05）. The intraoperative dectection rate of residual stones was higher in the trial group than in the control group （5.88% vs 0% ,P 〈 0. 05）. The residual stones rate after treatment was lower in the treatment than in the control group（ 0% vs 9. 52% ,P 〈0. 05）. No bile leakage happened in two groups. Conclusion ENBD improve the effect and the safety of the treatment mode of EST ＋ LC/LCBDE.