中国内镜杂志2025，Vol.31Issue(12)：56-63,8.DOI:10.12235/E20250208
单纯内镜乳头小球囊扩张术在胆总管较大结石中的应用效果及安全性
Effect and safety of endoscopic papillary small balloon dilation in the treatment of large calculus of common bile duct
摘要
Abstract
Objective To explore the clinical efficacy and safety of endoscopic papillary small balloon dilation(EPSBD)in treating large calculus of the common bile duct(diameter 10～15 mm).Methods The subjects of this study,142 patients with large calculus of the common bile duct(10～15 mm)from January 2020 to December 2023,were divided into the observation group and the control group by the random number table method,each with 71 cases.The observation group was administered with merely EPSBD(diameter 10 mm),while the control group was used the combination of endoscopic sphincterotomy(EST)and endoscopic papillary balloon dilation(EPBD).The perioperative related indicators(stone removal success rate,stone removal time,time of first defecation after surgery and hospital stay),liver function indicators[total bilirubin(TBiL),glutamic-pyruvic transaminase(GPT)and glutamic-oxaloacetic transaminase(GOT)]before and 48 hours after surgery were compared between the two groups of patients,as well as the occurrence of early and long-term complications after surgery.The situation of laparoscopic cholecystectomy(LC)performed within 12 months after the operation was compared.Results There were no statistically significant differences in the success rate of stone removal,the time of stone removal,the time of first defecation after surgery and the length of hospital stay between the two groups of patients(P>0.05).At 48 hours after the operation,the levels of serum TBiL,GPT and GOT in both groups were significantly lower than those before the operation,and the differences were statistically significant(P<0.05).However,there were no statistically significant differences between the two groups(P>0.05).The incidence of early postoperative complications in the observation group was 11.27%,compared with 8.45%in the control group,and the difference was not statistically significant(P>0.05).The incidence of long-term postoperative complications in the observation group was 2.82%,significantly lower than 16.90%in the control group,and the difference was statistically significant(P<0.05).Within 12 months after the operation,5 cases in the observation group and 4 cases in the control group underwent LC.There was no statistically significant difference between the two groups(P>0.05).Conclusion The application of EPSBD in the treatment of large calculus of the common bile duct(diameter 10～15 mm)can achieve a similar stone removal success rate compared with the EST+EPBD treatment regimen,but the former is more conducive to reducing the occurrence of long-term complications.It is worthy of clinical promotion and application.关键词
内镜乳头小球囊扩张术(EPSBD)/胆总管较大结石(直径10～15mm)/内镜十二指肠乳头括约肌切开术(EST)/术后并发症/奥迪括约肌/内镜治疗Key words
endoscopic papillary small balloon dilation(EPSBD)/large calculus of common bile duct(diameter 10～15 mm)/endoscopic sphincterotomy(EST)/postoperative complications/Oddi sphincter/endoscopic treatment分类
医药卫生引用本文复制引用
沈俊松,王翔,张莉莉,成凤干,刘新春,陈红芹..单纯内镜乳头小球囊扩张术在胆总管较大结石中的应用效果及安全性[J].中国内镜杂志,2025,31(12):56-63,8.基金项目
南京医科大学康达学院科研发展基金(No:KD2022KYJJZD098) （No:KD2022KYJJZD098）
