内镜逆行胰胆管造影治疗先天性胆总管囊肿切除术后胆总管残端结石

Efficacy and safety of endoscopic retrograde cholangiopancreatography in the treatment of stones in residual end of common bile duct after congenital choledochal cyst resection

目的 评估内镜逆行胰胆管造影术(ERCP)治疗胆总管残端结石的有效性及安全性。方法 收集2019年1月至2023年12月山东省立第三医院8例因腹痛入院诊断为先天性胆总管囊肿切除术后胆总管残端结石、再行内镜治疗的患者临床资料。分析ERCP操作成功率、结石取净率、并发症发生率、腹痛缓解率、结石复发率、癌变率。结果 8例患者结石直径(1.12±0.35)cm,结石数为(1.03±0.25)个,总操作成功率100%(8/8),一次结石取净率87.5%(7/8),总结石取净率100%(8/8)。术后1例患者出现轻度ERCP术后出血,8例患者腹痛均有不同程度缓解。术后随访6个月~2年,期间1例患者复发结石;1例患者复查发现早期壶腹肿瘤,行外科手术治疗。结论 ERCP治疗先天性胆总管囊肿切除术后胆总管残端结石是安全有效的。

objective To evaluate the efficacy and safety of endoscopic retrograde cholangiopancreatography(ERCP)in the treatment of stones in residual end of common bile duct.Methods The clinical data of 8 patients,who admitted to Shandong Provincial Third Hospital due to abdominal pain and diagnosed as stones in residual end of common bile duct after congenital choledochal cyst resection,and then received endoscopic treatment between Jan.2019 and Dec.2023,was retrospectively analyzed.The success rate of the ERCP operation,stone clearance rate,complication incidence rate,abdominal pain relief rate,stone recurrence rate,and canceration rate were analyzed.Results Among 8 patients,the average stone diameter was(1.12±0.35)cm,and the number of stones was(1.03±0.25).The overall success rate of ERCP operation was 100%(8/8),the first-time stone clearance rate was 87.5%(7/8),and the total stone clearance rate was 100%(8/8).One patient developed to mild post-ERCP bleeding.The abdominal pain of 8 patients were relieved to varying degrees.After 6 months to 2 years of follow-up,one patient was found with recurrent stones,one patient was found with early ampullary tumor and then received surgical treatment.Conclusion ERCP is effective and safe in the treatment of stones in residual end of common bile duct after congenital choledochal cyst resection.