胆总管结石取石后复发结石的内镜再治疗

Endoscpoic therapy for the recurrent stones of common bile duct after lithotomy

目的：观察内镜对胆总管结石取石后复发结石的治疗效果。方法：选择经上腹部CT或磁共振胰胆管成像（medical rehabititation center of pennsylvania,MRCP）证实、内镜下行胰胆管造影（endoscopic retrograde cholangiopancreatography,ERCP）术后胆总管再发结石48例,均经十二指肠乳头括约肌切开术（endoscopic sphincteropapillotomy,EST）,十二指肠乳头球囊扩张术（endoscopic papillo-sphincter balloon dilatation,EPBD）或EST＋EPBD后网篮或球囊取石。结果：48例中44例经内镜取石成功,手术时间为15-56min,平均29min。无一例并发症发生。结论：内镜治疗胆总管结石后可再发结石,经内镜再次取石是治疗EST术后胆总管结石复发的首选方法,安全有效。

Objective：To observe the effect of endoscopic therapy for recurrent stones of common bile duct after lithotomy. Methods：Forty-eight patients with recurrent stones of common bile duct confirmed by CT or MRCP, who had been treated by endoscopic sphincterotomy（EST）, endoscopic papillary balloon dilation （EPBD）, basket or balloon lithotomy after EST and EPBD were included in this study. Results： Endoscopic lithotomy was successfully performed in forty-four cases without any complication. The operation time was 15-56 min and the average was 29 min. Conclusion：Common bile duct stones could be recurrent after endoscopic treatment. Endoscopic lithotomy for recurrent common bile duct stones after EST is a safe, effective and preferred method.