CAJ | 학술논문

目的探讨经皮经肝球囊扩张术治疗胆总管结石的临床应用价值.方法自2008年10月至2010年2月选取60例胆总管结石患者,分成两组,分别为经皮经肝球囊扩张取石组(percutaneous transhepatic balloon dilation,PTBD)30例、单纯乳头括约肌切开取石组(endoscopicsphincterotomy,EST)30例.PTBD组经皮经肝穿刺置入球囊扩张十二指肠乳头后行球囊取石,EST组按常规操作.两组术后均常规引流3d.结果 PTBD组及EST组分别有28例(93％)及29例(97％)成功取净结石,术后早期并发症的总发生率分别为13％及17％.数据采用x2检验.60例无死亡病例.随访2年,EST组胆管结石复发率及反流性胆管炎发生率高于PTBD组(x2=6.41,P＜0.05).结论 PTBD取石具有与EST取石相近的成功率,且可保留乳头括约肌功能,PTBD可以作为胆总管结石的治疗措施,尤其是对不适于EST的患者.
목적 탐토경피경간구낭확장술치료담총관결석적림상응용개치.방법 자2008년10월지2010년2월선취60례담총관결석환자,분성량조,분별위경피경간구낭확장취석조(percutaneous transhepatic balloon dilation,PTBD)30례、단순유두괄약기절개취석조(endoscopicsphincterotomy,EST)30례.PTBD조경피경간천자치입구낭확장십이지장유두후행구낭취석,EST조안상규조작.량조술후균상규인류3d.결과 PTBD조급EST조분별유28례(93％)급29례(97％)성공취정결석,술후조기병발증적총발생솔분별위13％급17％.수거채용x2검험.60례무사망병례.수방2년,EST조담관결석복발솔급반류성담관염발생솔고우PTBD조(x2=6.41,P＜0.05).결론 PTBD취석구유여EST취석상근적성공솔,차가보류유두괄약기공능,PTBD가이작위담총관결석적치료조시,우기시대불괄우EST적환자.
Objective To evaluate the effectiveness and safety of percutaneous transhepatic balloon dilation for the removal of common bile duct stones.Methods 60 patients of common bile duct stone were divided into two groups:PTBD group (30 cases) and endoscopic sphicterotomy (EST) group (30 cases).Postoperatively biliary tract was drained for three days.Results All stones were removed in 28 patients (93％) in PTBD group and 29 cases (97％) in EST group.Early complications occurred in 13％ in PTBD patients and in 17％ in EST patients(x2 =0.35,x2 =0.13,P ＞0.05).There was no mortality in neither group.Long-term complications such as gallstone recurrence and cholangitis in PTBD group was significantly less than that in EST group (x2 =6.41,P ＜ 0.05).Conclusions The success rate of PTBD was similar to that of EST and while in PTBD the function of Oddi's sphincter was well reserved.PTBD procedure is a valuable alternative to EST in patients with bile duct stones,especially in patients who are not suitable for EST.