胆总管结石的内镜治疗进展

Progress of endoscopic treatment of choledocholithiasis

胆总管结石是一种常见病、多发病,其治疗方法多样,但微创治疗已逐渐成为首选。目前对于胆总管结石的内镜治疗主要包括内镜下十二指肠乳头括约肌切开取石术(EST)和内镜下乳头球囊扩张术(EPBD)。随着内镜技术的发展,EST和EPBD对常规胆总管结石的治疗效果已明显提高,但对于一些复杂性胆总管结石,效果却并不满意。近年来,有学者提出采用乳头括约肌切开联合内镜下乳头大球囊扩张术(EPLBD)治疗复杂性胆总管结石已取得良好效果。国内外关于该方法治疗胆总管结石的报道还较少。因此,本文拟对胆总管结石的内镜治疗方法进行综述并着重对大球囊扩张术进行介绍,以期能为该方法的临床应用提供一定的参考。

Choledocholithiasis is a common disease with varied treatment methods, but minimally invasive treatment has gradually become the first choice. The mainly methods for treatment of eholedocholithiasis include endoscopic sphincterotomy （EST） and endoscopic papillary balloon dilation （EPBD）. With the development of endoscopic tech- niques, the therapeutic effect of EST and EPBD on choledocholithiasis has been greatly increased, however, it is not satisfied for treatment of difficult cases. In recent years, some scholars have proposed that EST combined with endoscop- ic papillary large-ballon dilation （EPLBD） for treatment of difficult choledocholithiasis has achieved good results. The reports about this method for treatment of choledocholithiasis are relative less. Therefore, in this paper, the endoscopic treatment of choledocholithiasis reviewed and focused on the introduction of EPLBD, in order to provide a reference for the clinical application of this method.