内镜下十二指肠乳头气囊扩张术治疗胆总管结石的现状

Current Status of Endoscopic Papillary Balloon Dilation for the Treatment of Common Bile Duct Stones

胆总管结石已成为常见病,首选的内镜治疗方法为内镜下十二指肠乳头括约肌切开术(EST),但其有出血、穿孔、Oddi括约肌功能永久丧失等严重并发症。EST作为治疗胆总管结石唯一可替代的微创方法,避免了这些严重并发症,但在是否导致术后较高的急性胰腺炎发生率仍存在争议。近年来,有学者行小切口EST联合气囊扩张术治疗胆总管结石,认为可以兼顾两者的优点。

Common bile duct stone has become a common disease. Endoscopic sphincterotomy（ EST） as the first choice of endoscopic treatment,has serious complications including bleeding,perforation,and permanent loss of Oddi sphincter function. Endoscopic papillary balloon dilatation（ EPBD） as the only one alternative minimally-invasive treatment for common bile duct stones,can avoid these serious comlications. But it is controversial whether it leads to a high incidence of acute pancreatitis. In recent years,some combined limited EST and EPBD for removal of common bile duct stones have been reported,which is considered to have combined advantages of the two methods.