十二指肠乳头括约肌小切开及球囊扩张治疗胆总管结石临床观察

Clinical observation of duodenum small endoscopic sphincterotomy combined with papillary balloon dilatation in the treatment of choledocholithiasis

目的观察十二指肠乳头括约肌小切开及球囊扩张治疗胆总管结石的临床价值。方法 228例胆总管结石患者随机分成两组:一组(86例):行十二指肠内镜下乳头括约肌小切开术(SEST)+内镜下乳头球囊扩张术(EPBD);二组(142例):行SEST。对比两组效果。结果 216例成功取尽结石,其中SEST+EPBD 83例,成功率为96.51%,SEST 133例成功率为93.66%,差异无统计学意义(P>0.05);一组并发症少于二组,差异具有统计学意义(P<0.05);无穿孔,死亡等严重并发症。结论对胆总管结石患者行十二指肠乳头括约肌小切开加内镜下乳头球囊扩张术治疗有效、安全、经济,值得临床推广应用。

Objective To observe the clinical value of duodenum small endoscopic sphincterotomy combined with papillary balloon dilatation in the treatment of choledocholithiasis. Methods A total of 228 patients with choledocholithiasis were randomly divided into group one（n=86）： underwent duodenum small endoscopic sphincterotomy（SEST）＋endoscopic papillary balloon dilatation（EPBD）, and group two（n=142）： underwent SEST. Comparison was made between effects of the two groups. Results There were 216 cases received successful calculus removal. Among them there were 83 cases undergoing SEST＋EPBD, with the success rate as 96.51%, and 133 cases undergoing SEST, with the success rate as 93.66%. The difference had no statistical significance（P〈0.05）. The group one had fewer complications than the group two, and the difference had statistical significance（P〈0.05）. No severe complications, such as perforation and death, occurred. Conclusion Duodenum small endoscopic sphincterotomy combined with papillary balloon dilatation is effective, safe and economical in the treatment of patients with choledocholithiasis, and it is worthy of clinical promotion and application.