内镜下乳头球囊扩张术治疗胆总管结石的安全性和长期疗效

Safety and long-term outcomes of endoscopic papillary balloon dilation for removal of common bile duct stones

背景内镜下乳头球囊扩张术(endoscopic papillary balloon dilation,EPBD)是治疗胆总管结石(common bile duct stones,CBDSs)-种有效方法,但其安全性及长期疗效却缺乏评价.本研究拟分析EPBD治疗CBDSs的安全性和长期疗效.目的评估EPBD治疗CBDSs的安全性和长期疗效.方法分析我院2014-01/2015-12期间收治的CBDSs患者行EPBD的资料.主要观察指标为CBDSs清除率、内镜下逆行性胰胆管造影术(endoscopic retrograde cholangiopancreatography,ERCP)相关并发症和CBDSs复发率.结果42例CBDSs患者进行了EPBD,全部患者均完成了结石清除(100%).ERCP相关并发症发生4例(4/45,8.8%),均为术后胰腺炎,没有穿孔、出血及胆管炎的发生.在随后进行平均时间为51.8 mo(18-66 mo)随访中,10例(10/42,23.8%)患者CBDSs复发.单因素分析提示女性(比值比=22.891,95%可信区间:1.544-339.362,P=0.023)是结石复发的危险因素.结论EPBD治疗CBDSs是安全和有效的.长期随访发现,女性可能是结石复发的危险因素.

BACKGROUND Endoscopic papillary balloon dilation(EPBD) is an effective treatment for common bile duct stones(CBDSs),but there have been few evaluations on its safety and long-term outcomes.AIM To assess the safety and long-term outcomes of EPBD in the treatment of CBDSs.METHODS The clinical data of patients who underwent CBDSs removal by EPBD from January 2014 to December 2015 at our hospital were reviewed.The main outcomes were stone clearance,endoscopic retrograde cholangiopancreatography(ERCP)-related complications,and stone recurrence.RESULTS A total of 42 patients with CBDSs who underwent EPBD at our hospital were reviewed.The overall successful CBDSs clearance was 100%.ERCP-related complications occurred in four ERCP procedures,all of which were pancreatitis.There was no perforation,bleeding,or cholangitis.Ten(23.8%) of forty-two patients had CBDSs recurrence after a mean period of 51.8 mo(18-66 mo)from the end of EPBD.Female gender(odds ratio=22.891,95% confidence interval:1.544-339.362,P=0.023)was significantly related to stone recurrence.CONCLUSION EPBD is safe and effective in the removal of CBDSs.Female gender may be a risk factor for stone recurrence in a long term.