内镜下不同大小气囊乳头扩张术治疗胆总管结石近远期疗效比较

Comparison of short-term and long-term efficacies of choledocholithiasis treated with endoscopic papillary large- and small-balloon dilation

目的观察不同大小乳头气囊扩张术(EPBD)进行ERCP取石的近远期疗效。方法选取该院2007年8月-2011年11月入院治疗的90例胆总管结石患者为研究对象,根据不同直径的柱状气囊分为10及15mm两组,观察两组患者术后出血、胰腺炎、胆管炎及结石复发的情况,并进行比较分析。结果两组患者均在EPBD下取石成功,其中,两组取石时间、术后出血量、术后胰腺炎发生率无明显差异,而术后1、2年胆管炎发生率及结石复发率差异有显著性。结论在保证取石成功、保证患者安全的前提下,选用直径更小的气囊进行EPBD,可以减少患者胆管炎发生率及结石复发率。

【Objective】To observe the short-term and long-term efficacies of stone removal under endoscopic retrograde cholangiopancreatography（ERCP） by using endoscopic papillary balloon dilation（EPBD）.【Methods】90cases with choledocholithiasis admitted to our hospital from August 2008 to November 2011 were selected as study objects. Stones in two groups were taken under papillary dilation using columnar balloon with diameters of 1.0 cm and 1.5 cm, respectively. Cholangitis, pancreatitis and stone recurrence, as well as postoperative hemorrhage in two groups were compared. 【Results】Stones were successfully removed under EPBD in two groups; time for stone removal, postoperative hemorrhage and postoperative incidence of pancreatitis showed no significant differences in two groups while the incidence rates of cholangitis and stones one year and two years after surgery showed significant differences in two groups. 【Conclusion】 At the premise of successful lithotomy and patient＇s safety, balloon with smaller diameters should be selected for EPBD as which can reduce the recurrence rates of cholangitis and stone and therefore improve life quality of patients.