内镜下Oddi括约肌切开取石术后对胆囊功能影响的研究进展

Research progress in effect of endoscopic sphincterotomy of the sphincter of Oddi on gallbladder function

胆总管结石是临床常见病和多发病,近年来经十二指肠内镜取石已成为热门话题,并逐渐取代外科手术,且可获得良好的治疗效果。因需要切开Oddi括约肌以扩大十二指肠乳头的开口,术后会造成永久性损伤,导致一系列相关并发症发生。相关并发症研究多集中于胆管结石复发、胆管炎、胆管狭窄甚至胆管癌,但较少涉及胆囊功能。本文主要就Oddi括约肌切开术(EST)术后对胆囊功能影响的研究进展进行综述,发现EST术后胆囊的充盈和储存功能减弱,排空功能和收缩功能代偿性增强,浓缩能力发生异常,导致各种EST术后并发症发生率增加,因而应严格掌握EST术后胆囊切除的适应证。

Choledocholithiasis is a common and frequently-occurring disease in clinical practice.In recent years,endoscopic transduodenal stone removal has become a hot topic,which has gradually replaced surgery and can obtain favorable therapeutic effect.The sphincter of Oddi has to be incised to enlarge the opening of duodenal papilla,which can cause postoperative permanent injury and a series of related complications.Most studies have emphasized the recurrence of bile duct stones,cholangitis,bile duct stenosis and even cholangiocarcinoma,whereas gallbladder function has been rarely evaluated.In this article,research progresses in the effect of endoscopic sphincterotomy(EST)on gallbladder function were reviewed.The findings demonstrated that the filling and storage functions of gallbladder were weakened,the emptying and contraction functions were enhanced compensatorily,and the concentration capability became abnormal after EST.Consequently,the incidence of complications after EST was increased.Hence,the indications of cholecystectomy after EST should be strictly controlled.