经乳头胆道引流术在内镜治疗胆总管结石中的应用进展

Application progress of transpapillary biliary drainage in endoscopic treatment of choledocholithiasis

经乳头胆道引流术在胆总管结石及其并发症的内镜治疗中有着十分重要的作用,不同引流方式的益处及应用值得思考。归纳和总结了内镜鼻胆管引流术(ENBD)和内镜逆行胆道支架引流术(ERBD)在治疗不同病理状态下胆总管结石时的优势和劣势。多项研究证实,两种引流方式在治疗胆总管结石及其并发症中被证实同样安全、有效,ENBD在紧急胆道引流中发挥着重要作用,而ERBD在中长期处理难治性胆总管结石方面具有优势。指出在胆总管结石的内镜治疗策略及胆道引流方式不断变化的今天,小管径、猪尾型、可自行脱落或可降解的ERBD具有良好应用前景。

Transpapillary biliary drainage is important for the endoscopic treatment of choledocholithiasis and its complications. The benefits of various drainage approaches are worth considering. This article discusses the benefits and drawbacks of endoscopic nasobiliary drainage(ENBD) and endoscopic retrograde biliary drainage(ERBD) in endoscopic treatment of choledocholithiasis under different pathological conditions. According to research, although both drainage methods are equally safe and effective, ENBD plays an important role in emergency biliary drainage, while ERBD has advantages in the medium-and long-term treatment of refractory choledocholithiasis. With the ongoing evolution of biliary drainage in endoscopic treatment of choledocholithiasis, ERBD has a promising future due to its small diameter, pigtail type, self-shedding or biodegradable characteristics.