内镜球囊扩张治疗前后胆道压力临床分析96例

Biliary tract pressure before and after endoscopic papillary balloon dilation treatment for common bile duct stones

目的:探讨内镜球囊扩张(endoscopic papillary balloon dilation,EPBD)治疗前后对患者胆道压力的影响.方法:选择天津市南开医院微创外科中心2011-09/2014-01成功进行胆道测压和EPBD治疗的96例胆总管结石患者,对内镜前后胆道压力进行比较.结果:96例胆总管结石患者胆道测压结果相对高于正常值,胆囊切除术后患者较伴胆囊结石患者胆道压力略高,行EPBD可以有效缓解患者胆道高压.随访1.0-21.0 mo(平均11.8 mo±6.1 mo),除3例患者失访,余患者临床症状均缓解.术后高淀粉酶血症2例,急性胰腺炎2例,轻度胆管炎2例,均经非手术治疗后在24-72 h内恢复正常,并发症发生率为6.3%(6/96),无出血、穿孔、重症胰腺炎等内镜相关并发症发生,无死亡报道.结论:EPBD治疗可以有效解决患者胆道梗阻,减低胆道压力.

AIM：To determine the biliary tract pressure before and after endoscopic papillary balloon dilation（EPBD） treatment for common bile duct stones.METHODS：Clinical data for 96 patients with common bile duct stones who successfully underwent EPBD and biliary manometry from September 2011 to January 2014 wereretrospectively analyzed.RESULTS：Biliary tract pressure was significantly higher in patients with common bile duct stones than in healthy controls,which could be relieved by EPBD.Biliary tract pressure in patients who underwent cholecystectomy was higher than in patients with gallbladder stones.After operation,there were 2 cases of hyperamylasemia,2 cases of acute pancreatitis and 2 cases of mild cholangitis,all of which resolved after non-operative treatment.The incidence of complications was 6.3%（6/96）.No serious complications occurred.CONCLUSION：EPBD treatment can effectively solve biliary obstruction and reduce biliary pressure.