内镜下柱状球囊扩张取石治疗十二指肠乳头旁憩室合并胆总管结石

摘要

Objective To evaluate the use of endoscopic papillary balloon dilation in treatment of choledocholithiasis associated with peripapillary duodenal diverticulum.Methods From January 2017 to July 2018,a retrospective study was conducted on 124 patients with choledocholithiasis associated with peripapillary duodenal diverticula at the Department of Hepatobiliary Surgery,Second Hospital of Hebei Medical University.These patients were divided into the small endoscopic sphincterotomy combined with balloon dilation group (sEST+EPBD,n =60) and the simple papillary balloon dilation group (EPBD n =64).The operation time,one-time success rate of stone removal,complication and hospitalization stay were compared between the two groups of patients.Results The hospitalization expenses of the EPBD group was significantly less than the sEST+EPBD group (P＜0.05).The operation time of the EPBD group was significantly shorten than the sEST+EPBD group (P＜0.05).There were no significant differences in the one-time success rate of stone removal,complication rates and hospitalization stay between the two groups (P＞0.05).Conclusions Compared with sEST+EPBD,treatment of choledocholithiasis in patients with peripapillary duodenal diverticula using simple balloon dilation shortened the operation time,did not increase the complication rates and hospitalization stay.The procedure was safe and effective,and resulted in almost the same one-time success rate of stone removal.%目的 评价内镜下单纯柱状球囊扩张取石(EPBD)在十二指肠乳头旁憩室合并胆总管结石患者的应用价值.方法 回顾性分析2017年1月至2018年7月河北医科大学第二医院肝胆外科收治的十二指肠乳头旁憩室合并胆总管结石患者124例,将患者分为十二指肠乳头旁憩室小切开+柱状球囊扩张治疗组(sEST+EPBD组,n=60)和十二指肠乳头旁憩室单纯柱状球囊扩张治疗组(EPBD组,n=64),比较两组之间的一次性取石成功率、手术操作时间、术后并发症、术后住院时间等指标.结果 EPBD组的手术操作时间低于sEST+EPBD组(P＜0.05);两组间的一次性取石成功率、术后并发症发生率及术后住院时间相比差异无统计学意义(P＞0.05).结论 与sEST+EPBD相比,单纯行EPBD治疗十二指肠乳头旁憩室合并胆总管结石,具有操作简单、安全、有效、术者易掌握、手术时间短,且不增加术后并发症及患者住院时间等特点,且两种手术方式一次性取石成功率相当.