CAJ | 학술논문

目的探讨内镜十二指肠乳头大球囊扩张(EPLBD)治疗憩室旁乳头合并胆总管大结石的有效性与安全性.方法共87例十二指肠乳头旁憩室合并胆总管大结石的患者,EPLBD组45例采用内镜十二指肠乳头大球囊扩张术取石;EST组42例行常规内镜下乳头括约肌切开取石术.观察2组患者Ⅰ期取石成功率、取石时间、术中碎石率和术后并发症情况.结果 EPLBD组Ⅰ期取石成功率为91.1％,EST组为92.9％,组间比较差异无统计学意义(P＞0.05).取石时间EPLBD组为(25.48±7.92) min,EST组为(35.56±9.23) min,碎石率分别为16.3％和34.6％,EPLBD组明显少于EST组,组间比较差异有统计学意义(P＜0.05).EPLBD组及EST组术后出血、术后胰腺炎、胆管炎发生率相当,差异无统计学意义(P＞0.05).2组均无穿孔及死亡病例.结论内镜十二指肠乳头大球囊扩张术治疗乳头旁憩室合并胆总管大结石可以缩短取石时间,减少术中碎石率,是一种安全、有效的治疗方法.
목적 탐토내경십이지장유두대구낭확장(EPLBD)치료게실방유두합병담총관대결석적유효성여안전성.방법 공87례십이지장유두방게실합병담총관대결석적환자,EPLBD조45례채용내경십이지장유두대구낭확장술취석;EST조42례행상규내경하유두괄약기절개취석술.관찰2조환자Ⅰ기취석성공솔、취석시간、술중쇄석솔화술후병발증정황.결과 EPLBD조Ⅰ기취석성공솔위91.1％,EST조위92.9％,조간비교차이무통계학의의(P＞0.05).취석시간EPLBD조위(25.48±7.92) min,EST조위(35.56±9.23) min,쇄석솔분별위16.3％화34.6％,EPLBD조명현소우EST조,조간비교차이유통계학의의(P＜0.05).EPLBD조급EST조술후출혈、술후이선염、담관염발생솔상당,차이무통계학의의(P＞0.05).2조균무천공급사망병례.결론 내경십이지장유두대구낭확장술치료유두방게실합병담총관대결석가이축단취석시간,감소술중쇄석솔,시일충안전、유효적치료방법.
Objective To investigate the effectiveness and safety of endoscopic papillary large-balloon dilation(EPLBD) for juxtapapillary duodenal diverticulum(JPD)combined with large common bile duct stones.Methods A total of 87 patients with juxtapapillary duodenal diverticulum and large common bile duct stones were randomly divided to 2 groups.Forty-five cases received endoscopic papillary large-balloon dilation(EPLBD group) as the treatment group,and 42 cases were treated by conventional endoscopic sphincterotomy(EST group) as the control group.The success rate of stone clearance in a single session,operation time,the rate of mechanical lithotripsy and complications were observed.Results Stone clearance in a single session of 2 groups were 91.1％ (EPLBD group)and 92.9％ (EST group) respectively with no significant difference(P ＞ 0.05).The stone removal time were (25.48 ± 7.92) min in EPLBD group and(35.56 ± 9.23) min in EST group (P ＜ 0.05).The rate of mechanical lithotripsy were 16.3％ and 34.6％ in two groups with significant differences.Rates of bleeding,postoperrative pancreatitis and cholangitis in two groups were similar(P ＞ 0.05).No death happened in any group.Conclusion EPLBD is a safe and effective method for clearance of large common bile duct stones combined with juxtapapillary duodenal diverticulum which can reduce the occurrence of mechanically breaking stone and operation time.