困难胆总管结石的内镜治疗进展

Advances in endoscopic therapy for difficult common bile duct stones

胆总管结石是一种常见的胆道疾病,首选治疗方式为内镜治疗,但部分胆总管结石难以通过常规内镜治疗清除,被称为困难胆总管结石。困难胆总管结石治疗方法包括内镜下乳头大球囊扩张术、机械碎石术、经口胆道镜辅助碎石和体外冲击波碎石等。就上述技术治疗困难胆总管结石的适应证、临床疗效和不良事件等进展作一综述。

Common bile duct stones(CBDSs)are a common biliary tract disease,and endoscopic therapy is the first-line treatment modality for this disease;however,some CBDSs are difficult to remove by conventional endoscopic techniques and are thus called difficult CBDSs.Therapies for difficult CBDSs include endoscopic papillary large balloon dilation,mechanical lithotripsy,choledochoscopy-assisted lithotripsy,and extracorporeal shockwave lithotripsy.This article reviews the advances in the above mentioned techniques for the treatment of difficult CBDSs,including indications,clinical effect,and adverse events.