内镜下乳头气囊扩张术治疗胆囊切除术后胆总管结石

Endoscopic papillary balloon dilatation in management of common bile duct stone after cholecystectomy

目的 探讨经内镜乳头气囊扩张术 (EPBD)治疗胆囊切除术后胆总管结石的安全性和疗效。方法 对胆囊切除术后出现黄疸或胆管炎的 31例病人 ,利用EPBD结合取石篮、取石球囊或总攻方法 ,使梗阻于胆总管下段的结石排入肠道。结果 31例病人全部顺利实施EPBD ,共排除结石37颗 ,4例行 2次扩张术 ,术后病人均痊愈出院 ,复查B超无结石残存或胆管扩张。结论 经内镜治疗胆囊切除术后胆总管结石 ,安全、无创、有效 ,有望成为治疗LC术后胆总管结石的首选方法。

Objective To evaluate the efficacy and safety of endoscopic papillary balloon dilatation (EPBD) in management of common bile duct stone after cholecystectomy. Methods A total of 31 patients with common bile duct stone after cholecystectomy were admitted to our hospital for EPBD to remove the stones. Using basket or balloon tripped catheter or Chinese medicine, the stones blocking in the end section of the common bile duct were driven out to the intestines. Results All the patients received EPBD and the number of excreted stones were 37. Four patients underwent EPBD twice. All the patients were cured and discharged from the hospital. Ultrasonography showed that there was no residual calculus and dilatation of the bile duct. Conclusions EPBD is a safe, non invasive and effective means for treatment of common bile duct stone after cholecystectomy and can be of first choice for the treatment.