重庆医学2017，Vol.46Issue(36)：5098-5100,3.DOI:10.3969/j.issn.1671-8348.2017.36.019
内镜下十二指肠乳头括约肌切开术后肠胆反流的发生因素分析
Occurrence factors analysis of duodenobiliary reflux after endoscopic duodenal sphincterotomy
摘要
Abstract
Objective To investigate the occurrence factors of duodenobiliary reflux (DBR) after endoscopic sphincterotomy (EST ) .Methods A total of 198 patients with choledocholithiasis hospitalized in the digestive department of the hospital from Sep-tember 2012 to February 2016 were selected and given duodenal papilla EST .The DBR occurrence was judged and the occurrence factors were investigated ,meanwhile the Oddi sphincter function was measured and long term complications were followed up .Re-sults All patients successfully completed EST ,the average common bile duct diameter in 198 cases was (2 .24 ± 0 .24)cm ,the aver-age common bile duct stones number was 3 .63 ± 1 .12 ;the maximum diameter of common bile duct stones was (1 .02 ± 0 .19)cm . There were 12 cases of DBR after EST ,the occurrence rate was 6 .1% ,the average radioactivity was (3 .39 ± 0 .89)MBq .The post-operative Oddi sphincter systolic peak and contraction frequency were (31 .49 ± 4 .22)mm Hg and (3 .78 ± 0 .53) times /min ,which were significantly lower than those before operation (P<0 .05);and the postoperative Oddi sphincter basic pressure and common bile duct pressure were (8 .23 ± 1 .03)mm Hg and (3 .32 ± 0 .45)mm Hg respectively ,which had no statistical difference compared with preoperation (P>0 .05) .The Logistic regression analysis showed that complicating gallbladder stone ,diameter of common bile duct ,frequency difference of Oddi sphincter contraction before and after operation ,number of stones and maximum diameter of stone were the main risk factors for postoperative DBR occurrence (P<0 .05) .All cases were followed up for 6 months ,18 cases developed long term complications ,the incidence rate was 9 .1% ,including 4 cases of reflux cholangitis ,6 cases of bile duct stric-ture ,4 cases of papillary stenosis and 4 cases of recurrence .Conclusion DBR after duodenal papilla EST is common ,which can re-sult in the Oddi sphincter function decrease and increase of long-term complications ,and needs to actively strengthen prevention and management .关键词
括约肌切开术,内窥镜/胰腺管/肠胆反流/危险因素/奥狄括约肌Key words
sphincterotomy/endoscopic/pancreatic ducts/duodeno biliary reflux/risk factors/sphincter of Oddi分类
医药卫生引用本文复制引用
钟文洲,陈正义,林松挺,黄晓曦..内镜下十二指肠乳头括约肌切开术后肠胆反流的发生因素分析[J].重庆医学,2017,46(36):5098-5100,3.基金项目
海南省卫生厅项目(琼卫2011-59 ). （琼卫2011-59 ）
