经内镜乳头括约肌切开术治疗胆总管结石108例临床分析

Clinical Analysis of Endoscopic Sphincterotomy in 108 Patients with Common Bile Duct Stone

目的 :探讨经内镜乳头括约肌切开术 (EST)治疗胆总管结石的临床效果。方法 :EST治疗胆总管结石 1 0 8例。其中结石直径 <0 .5cm 1 2例 ,0 .6～ 1 .0cm 38例 ,1 .1～ 1 .5cm 30例 ,1 .6～ 2 .0cm 1 3例 ,2 .1～ 2 .5cm 9例 ,>2 .5cm 6例。单颗结石 68例 ,2颗结石2 7例 ,3颗以上结石 1 3例 ,最多的 1例结石 1 4颗。结果 :EST取石成功 1 0 5例 ,成功率 97.2 % ,失败 3例。采用取石网篮、取石球囊和机械碎石网篮取石。EST术后并发症 6例 ,发生率 5 .6 %。其中切口出血 3例 ,急性胰腺炎 2例 ,重症胆管炎 1例。随访 88例 ,时间 1个月～ 2年 ,全身状况良好 ,B超或CT检查无再发结石。结论 :经内镜乳头括约肌切开术是一种治疗胆总管结石安全。

Purpose: To evaluate the clinical effect of endoscopic sphincterotomy(EST) in patients with common bile duct stone. Methods: Among 108 patients with common bile duct stone, 12 patients whose stone size <0.5 cm, 38 patients whose stone size 0.6～1.0 cm, 30 patients whose stone size 1.6～2.0 cm, 9 patients whose stone size 2.1～2.5 cm, 6 patients whose stone size greater than 2.5 cm, 68 patients have only one stone, 27 patients have two stones, 13 patients have more than 3 stones, 1 patient has the maximum 14 stones. Results: EST was succeeded in 105 patients, the success rate of EST for the treatment of common bile duct stone was 97.2%.Stones were removed by endoscopic balloon, basket and mechanical lithoclasty basket. 6 patients developed complications, accounting for 5.6%. Among these patients, 3 patients complicated bleeding of incisions, 2 patients produced acute pancreatitis, 1 patients developed severe cholangitis. 88 patients undergoing follow-up for the duration from 1 month to 2 years were found to be in good conditions, no relapse occurred by B ultrasound or CT scan examination. Conclusion: EST is a safe and effective technique for treating patients with common bile duct stone.