经内镜乳头括约肌切开术小切开联合球囊扩张术治疗十二指肠乳头旁憩室的胆总管结石的疗效分析

Endoscopic Sphincterotomy with Small Incision Combined with Balloon Dilatation in the Treatment of Choledocholithiasis with Periampullary Diverticula

目的评价经内镜乳头括约肌切开术小切开联合内镜下乳头球囊扩张术(s EST+EPBD)治疗老年乳头旁憩室合并胆总管结石的疗效。方法回顾性分析103例65岁以上乳头旁憩室合并胆总管结石患者,按手术方法分为s EST+EPBD组(61例)与EST组(41例),比较两组的结石一次取净率、碎石器使用率及术后并发症情况。结果 s EST+EPBD组与EST组相比结石一次取净率更高(91.93%vs 78.04%,P=0.044),碎石器使用率更低(8.060%vs 21.95%,P=0.044)。结论对于PDD合并胆总管结石的患者治疗合并PDD的胆总管结石,可提高一次性取石成功率,是一种安全、有效的治疗方法。

Objective To explore the efficacy and safety of endoscopic sphincterotomy with small incision combined with balloon dil- atation （sEST ＋ EPBD） in the treatment of choledocholithiasis with periampullary diverticula（PAD）. Methods 103 patients with chole- docholithiasis and PAD who underwent endoscopic retrograde cholangio -pancreatography （ERCP） were enrolled. Among them, 62 pa- tients were in sEST ＋ EPBD group, 41 patients were in EST group randomly, The clinical data was retrospectively analyzed. Results Compared with EST group,the sEST ＋ EPBD group had a higher success rate of the complete stone removal in the first session（91.93% vs 78.04% ,P = 0. 044） ,lower rate of mechanical lithotripsy（ 8. 06% vs 21.95% , P = 0. 044）. The overall stone removal rates showed no difference（ 100% vs 100% ）. There was no significant difference post operative complications between the two groups（8. 06% vs 21. 95% ,P = 0. 044）. Conclusion SEST ＋ EPBD could increase the first - time success rate of stone removal in patients with choledocholi- thiasis and PAD,and it is a safe and effective treatment.