内镜治疗非扩张性肝外胆管结石68例

Report of 68 cases after endoscopic - intervention for non - dilated extrahepatic billiary stones

目的 探讨非扩张性肝外胆管结石的病因、诊断,分析内窥镜下十二指肠乳头切开术（endo-scopic sphincterotomy,EST）的治疗效果。方法 对1993-2001年治疗的68例患者进行回顾性分析。界定非扩张性肝外胆管结石的概念,对该类患者采取EST+网篮取石治疗,术后进一步通过腹腔镜胆囊切除术或开腹胆囊切除术治疗。结果 非扩张性肝外胆管结石多为继发性胆总管结石,多数直径≤0.5cm,少数为原发性胆总管结石,常合并十二指肠乳头肌狭窄或十二指肠乳头旁想室。结论 逆行性胰胆管造影（enda-scopic retrograde cholangiopancreatography,ERCP）检查对非扩张性肝外胆管结石诊断阳性率高,EST治疗非扩张性肝外胆管结石疗效显著。

Objective To investigate the pathogenesis and diagnosis of non- dilated extrahepatic billiary stones and analyze the effect of endoscopic sphineterotomy (EST) . Methods 68 patients with non - dilated extrahepatic billiary stones from 1993 to 2001 were retrospectively analyzed. After defining the conception of non - dilated extrahepatic billiary stones, we treatted these patients with EST and basket- extracting. Once the surgery had been finished, laparo-scopic cholecystectomy (LC) or operative cholecystectomy therapy was furthermore performed. Results Most of non -dilate extrahepatic billiary stones were secondary common bile duct stones, with diameter lessthan 0.5 cm and minority were primary common bile duct stones always combined with stenosing papillitis of vater or duodenal diverticulum. Conclusions Endoscopic retrograde cholangiopancreato graphy (ERCP) is useful in diagnosis non - dilated extrahepatic billiary stones, and EST is efficient for treatment of non - dilated extrahepatic billiary stones.