CAJ | 학술논문

目的探讨内镜下乳头切开术(EST)与外科手术治疗胆总管结石合并肝硬化病例疗效及并发症情况的比较.方法 1985年8月至2008年5月间,胆总管结石合并肝硬化患者中139例行EST术,98例行外科手术作为对照组.结果 EST组和外科手术组取石成功率分别为95%和100%.术后并发症发生率EST组为16.5%,外科手术组为62.2%;术后死亡率EST组为5.0%,外科手术组为24.5%,两组差异均有统计学意义.并发症发生率与肝功能Child-Push分级关系:A级,两组比较差异无统计学意义,而B级与C级,两组比较差异有统计学意义.死亡率与肝功能Child-Push分级关系:A级与B级,两组比较差异无统计学意义,而C级,两组比较差异有统计学差异.结论与外科手术相比,EST治疗胆总管结石合并肝硬化可显著减少术后并发症发生率和死亡率,取石成功率高达95%.
목적 탐토내경하유두절개술(EST)여외과수술치료담총관결석합병간경화병례료효급병발증정황적비교.방법 1985년8월지2008년5월간,담총관결석합병간경화환자중139례행EST술,98례행외과수술작위대조조.결과 EST조화외과수술조취석성공솔분별위95%화100%.술후병발증발생솔EST조위16.5%,외과수술조위62.2%;술후사망솔EST조위5.0%,외과수술조위24.5%,량조차이균유통계학의의.병발증발생솔여간공능Child-Push분급관계:A급,량조비교차이무통계학의의,이B급여C급,량조비교차이유통계학의의.사망솔여간공능Child-Push분급관계:A급여B급,량조비교차이무통계학의의,이C급,량조비교차이유통계학차이.결론 여외과수술상비,EST치료담총관결석합병간경화가현저감소술후병발증발생솔화사망솔,취석성공솔고체95%.
Objective To compare the therapeutic efficacy and procedure related complications between endoscopic sphincterotomy (EST) and surgery in treatment for choledocholithiasis concomitant with liver cirrhosis. Methods The data of patients with choledocholithiasis concomitant with cirrhosis who underwent EST (n = 139 ) or surgery (n =98 ) for stone clearance from August 1985 to May 2008,were retrospectively analyzed and compared. Results The success rates of complete stone clearance in EST and surgery groups were 95% and 100%,respectively. There was a significant difference in the rate of procedure-related complications between EST and surgery groups ( 16. 5% vs. 62. 2%,P ＜ 0. 01 ),as well as the mortality rate (5.0% vs. 24. 5% ). When patients were further grouped according to Child-Pugh liver function classification,a significant difference in rate of procedure-related complications was detected between 2 groups in patients of Child-Pugh B and C,as well as the mortality rate in patients of Child-Pugh C. Conclusion For patients with choledocholithiasis concomitant with liver cirrhosis,EST,with a stone clearance rate at 95%,is superior to surgery with a significant reduction in risk of procedure-related complication and mortality rate.