内镜下乳头括约肌球囊扩张术治疗胆总管结石的安全性和有效性分析
Safety and efficacy of endoscopic papillary balloon dilation in the treatment of common bile duct stones
高悦悦 1陶凯歌 1朱美玲 1刘加宁 1李运红1
作者信息
- 1. 徐州医科大学附属宿迁医院 消化内科,江苏 宿迁 223800
- 折叠
摘要
目的 评价内镜下乳头括约肌球囊扩张术治疗胆总管结石的安全性和有效性.方法 回顾性选取2015年1月—2022年10月在徐州医科大学附属宿迁医院接受内镜治疗胆总管结石的284例患者,术中的球囊扩张时间均为5 min,依手术方式分为内镜下乳头括约肌切开术(37例)、内镜下乳头括约肌球囊扩张术(49例)及内镜下乳头括约肌小切开联合球囊扩张术(198例)3组,收集患者的人口学特征、临床特征及短期并发症等资料并分析安全性和有效性.结果 安全性方面,内镜下乳头括约肌球囊扩张术组术中出血发生率(6.1%)明显低于内镜下乳头括约肌切开术组(29.7%)以及内镜下乳头括约肌小切开联合球囊扩张术(26.3%)组,差异有统计学意义(P=0.003).3组患者间的其他短期并发症发生率差异无统计学意义.有效性方面,3组患者的首次结石清除率和机械碎石率差异无统计学意义.结论 内镜下乳头括约肌球囊扩张术手术安全有效,且术中出血风险更低,临床应用具有价值.
Abstract
Objective To evaluate the safety and efficacy of endoscopic papillary balloon dilation(EPBD)in the treatment of common bile duct stones.Methods A total of 284 patients who received endoscopic treatment for common bile duct stones in Affiliated Suqian Hospital of Xuzhou Medical University from January 2015 to October 2022 were selected as the study objects and divided into three groups,namely endoscopic sphinc-terotomy(EST)(37),EPBD(49)and EST+EPBD(198),according to endoscopic methods.The demographic characteristics,clinical characteristics and short-term complication rate of these patients were retrospectively collected.The safety and efficacy of them were analyzed.Results In terms of safety,the incidence of intra-operative bleeding in the EPBD group(6.1%)was significantly lower compared to that in the EST group(29.7%)and the EST+EPBD group(26.3%),demonstrating statistical significance(P=0.003).There were no statistical differences observed among the three groups.Regarding effectiveness,there were no signifi-cant differences found in both the first stone clearance rate and mechanical lithotripsy rate among the three groups.Conclusion EPBD surgery is safe and effective,and the risk of intraoperative bleeding is lower,thus worthy of clinical application.
关键词
内镜下乳头括约肌切开术/内镜下乳头括约肌球囊扩张术/胆总管结石/内镜逆行胰胆管造影Key words
endoscopic sphincterotomy/endoscopic papillary balloon dilation/common bile duct stone/endo-scopic retrograde cholangiopancreatography引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据