内镜下十二指肠乳头括约肌柱状气囊扩张术用于胆总管结石取石术中的效果

Effect of Endoscopic Papillary Balloon Dilatation in Lithotomy of Common Bile Duct Stones

目的:探讨内镜下十二指肠乳头括约肌柱状气囊扩张术(endoscopic papillary balloon dilatation,EPBD)用于胆总管结石取石术中的疗效及安全性。方法:回顾分析应用EPBD治疗的76例胆总管结石患者的临床资料。结果:76例患者中73例成功取出胆总管结石,成功率96.1%,平均手术时间(30±12)min;无肠穿孔发生;术中发生活动性渗血5例,经局部喷洒去甲肾上腺液或黏膜下注射1∶10000肾上腺素液后成功止血;术后并发急性胰腺炎1例,高淀粉酶血症8例,均经保守治疗痊愈;平均住院时间(3±0.5)d。结论:采用EPBD行胆总管结石取石术具有安全、操作时间短、创伤小、恢复快、并发症少等优点。

Objective：To explore the efficacy and security of endoscopic papillary balloon dilatation（EPBD）in lithotomy of common bile duct stones.Methods：The clinical data of 76 patients with common bile duct stones who underwent EPBD were retrospectively analyzed.Results：The common bile duct stones were successfully removed in73 of the 76 patients.The success rate was 96.1% while the mean operative time was（30±12）min.There was no intestinal perforation.Five cases suffered intraoperative active bleeding which was successfully stopped by topical spraying norepinephrine or submucosal injection of 1∶10000epinephrine.One case was complicated by postoperative acute pancreatitis while eight cases had hyperamylasemia.All the cases above were cured by conservative treatment.The average length of hospital stay was（3±4.5）d.Conclusions：The application of EPBD is safe in lithotomy of common bile duct stones,which has the advantage of short operative time and small trauma,quick recovery and few complications.