中国内镜杂志2024，Vol.30Issue(5)：23-28,6.DOI:10.12235/E20230360
胆总管冲洗对减少胆管取石术后残石的影响
Effect of common bile duct irrigation on reducing residual stone after bile duct lithotomy
摘要
Abstract
Objective Rinse the common bile duct with 100 mL of 0.9%sodium chloride injection after choledocholithotomy to observe if it can improve the clearance rate of residual stones.Methods A study enrolled patients receiving endoscopic retrograde cholangiopancreatography(ERCP)and mechanical lithotripsy for calculus of common bile duct(≥12 mm)were conducted.After occlusion cholangiography confirmed common bile duct stone clearance,intraductal ultrasonography(IDUS)was performed to determine clearance scores based on the number of residual stones.The amounts of residual stones spotted via IDUS were graded,a large amount of stone fragments scored 1,a small amount of stone fragments scored 2,completely cleared common bile duct without any biliary sludge scored 3.After clearing calculus of common bile duct in ERCP and rinsing with 50 mL and 100 mL 0.9%sodium chloride injection,IDUS examination was performed and scored.Results No patient had common bile duct clearance scores of reached 3 without saline irrigation,45(40.18%)patients reached 3 with 50 mL 0.9%sodium chloride injection irrigation,and 99(88.39%)patients reached 3 with 100 mL irrigation.Multivariate Logistic regression analysis showed that common bile duct diameter>15 mm[odds ratio(O＾R)=4.90,95%confidence interval(CI):1.19～22.57,P=0.013],angulation of the distal common bile duct(the angle between the axis of the common bile duct and the ampulla axis of the common bile duct in cholangiography)≤140°(O＾R=6.92,95%CI:1.83～38.98,P=0.047)and duodenal diverticulum(O＾R=4.10,95%CI:1.14～16.90,P=0.041)were independent risk factors for failure to rinse with 100 mL 0.9%sodium chloride injection.Conclusion Irrigation with 100 mL 0.9%sodium chloride injection can effectively remove the residual calculus of common bile duct after lithotripsy.关键词
内镜逆行胰胆管造影术(ERCP)/管腔内超声检查术(IDUS)/胆总管结石/胆总管残石/冲洗Key words
endoscopic retrograde cholangiopancreatography(ERCP)/intraductal ultrasonography(IDUS)/calculus of common bile duct/residual stones in the common bile duct/irrigation分类
医药卫生引用本文复制引用
叶亮,李运泽,蔡怀阳..胆总管冲洗对减少胆管取石术后残石的影响[J].中国内镜杂志,2024,30(5):23-28,6.基金项目
广西壮族自治区卫健委计划课题(No:Z-B20231339) （No:Z-B20231339）
