内镜逆行胰胆管造影、十二指肠乳头小切开联合乳头括约肌气囊扩张术治疗肝外胆管结石的临床疗效

Effect of endoscopic retrograde cholangiopancreatography and duodenal papilla small incision joint nipple sphincter balloon dilatation in treating extrahepatic bile duct stone

目的探讨内镜逆行胰胆管造影(ERCP)、十二指肠乳头小切开联合乳头括约肌气囊扩张术(EPBD)治疗肝外胆管结石的临床疗效。方法选取2013年5月—2015年5月山西省太钢总医院收治的肝外胆管结石患者180例,随机分为对照组与治疗组,各90例。对照组患者予以ERCP+内镜乳头括约肌切开取石术(EST)治疗,治疗组患者予以ERCP+EPBD治疗。观察两组患者临床疗效、手术时间、术中出血量、疼痛缓解时间、引流退黄时间、术后体温恢复正常时间及并发症发生情况。结果治疗组患者总有效率高于对照组,手术时间短于对照组,术中出血量少于对照组,疼痛缓解时间、引流退黄时间、术后体温恢复正常时间短于对照组,并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论 ERCP+EPBD治疗肝外胆管结石的临床疗效显著,可改善患者临床症状,缩短患者手术时间,降低患者术中出血量,且并发症少。

Objective To explore the effect of endoscopic retrograde cholangiopancreatography(ERCP)and duode-nal papilla small incision joint nipple sphincter balloon dilatation(EPBD)in treating extrahepatic bile duct stone. Methods A total of 180 patients with extrahepatic bile duct stone were selected in the Taigang General Hospital of Shanxi Province from May 2013 to May 2015,they were randomly divided into control group and treatment group,90 cases in each group. Control group were given ERCP + endoscopic sphincterotomy(EST)treatment,treatment group were given ERCP + EPBD treatment. Clinical effect,operation time,intraoperative blood loss,the time alleviating pain,drainage of yellow back time,postoperative body temperature returned to normal time and rence of complications between the two groups were compared. Results The total effec-tive rate of treatment group was higher than that of control group(P < 0. 05),operation time of treatment was shorter than that of control group,intraoperative blood loss of treatment group was less than that of control group(P < 0. 05),the time alleviating pain,drainage of yellow back time,postoperative body temperature returned to normal time of treatment group were shorter than those of control group(P < 0. 05),complication rate of treatment group was lower than that of control group(P < 0. 05). Con-clusion ERCP + EPBD have notable curative effect in the treatment of extrahepatic bile duct stone,can improve clinical symp-toms,shorten the operation time patients,reduce the bleeding amount of patients and fewer complications.