摘要
目的探究十二指肠乳头括约肌切开术（endoscopic sphincteropapillotomy，EST）联合气囊扩张术（endoscopic papillo-sphincter balloon dilatation，EPBD）治疗胆总管结石合并十二指肠乳头旁憩室的临床价值。方法回顾性分析2014年1月至2016年5月166例胆总管结石合并十二指肠乳头旁憩室的患者，其中单用EST治疗的患者50例为EST组，单用EPBD治疗的患者50例为EPBD组，EST联合EPBD治疗的患者66例为联合组，比较两组患者一次性取石成功率、复发率及并发症发生率的差异。结果联合组一次性取石成功率（97．0％）高于单用EST组（90．0％）和单用EPBD组（92．0％），但差异无统计学意义（P〉0．05）。联合组出血发生率（3．0％）明显低于EST组（12．0％），差异有统计学意义（P〈0．05），与单用EPBD组（2．0％）比较差异无统计学意义（P〉0．05）。联合组急性胰腺炎或高淀粉酶血症的发生率（6．1％）明显低于EPBD组（26．0％），差异有统计学意义（P〈0．05）。术后三组患者间穿孔的发生率差异无统计学意义（P〉0．05）。联合组复发率（3．0％）与单用EST组（6．0％）和单用EPBD组（4．0％）比较，差异无统计学意义（P〉0．05）。结论EST与EPBD联合治疗胆总管结石合并十二指肠乳头旁憩室能提高手术成功率且降低部分并发症的发生率，是更加有效、安全的治疗方式。
Objective To explore the clinical value of endoscopic sphincterotomy （EST） combined with endoscopic papillo-sphincter balloon dilatation （EPBD） in the treatment of choledocholithiasis complicating by duodenal diverticulum. Methods 166 cases of choledocholithiasis complicating by duodenal diverticulum from January 2014 to May 2016 were retrospectively analyzed, 50 cases treated by EST as EST group, 50 cases treated by EPBD as EPBD group, 66 cases treated by EST combined with EPBD as combination group. The one-time success rate of stone removal, the recurrence rate, and the complication rate were compared between the two groups. Results The one-time success rate of stone removal in the combination group （97.0%） was significantly higher than that in EST group （90.0%） and EPBD group （92.0%）, but without statistically significant difference （P〉0.05）. The rate of bleeding in the combination group （3.0%） was significantly lower than that in EST group （12.0%） （P〈0.05）, but without statistically significant difference compared with EPBD group （2.0%） （P〉0.05）. The rate of acute pancreatitis and hyperamylasemia in the combination group （6.1%） was significantly lower than that in EPBD group （26.0%）, with statistically significant difference （P〈0.05）. There was no statistically significant difference in the rate of perforation among the three groups （P〉0.05）. There was no statistically significant difference in the recurrence rate among the combination group （3.0%）, EST group （6.0%）, EPBD group （4.0%） （P〉0.05）. Conclusion EST combined with EPBD in the treatment of choledocholithiasis complicating by duodenal diverticulum can improve the success rate of surgery and reduce some complications, is a kind of more effective and safer treatment method.
出处
《国际医药卫生导报》
2017年第24期3881-3884,共4页
International Medicine and Health Guidance News
