ZHANG Duoqiang 1WANG Juncheng 1MA Songbo 1WU Lang1
作者信息
- 1. Department of Hepatobiliary Surgery,Ningxia Hui Autonomous Region People's Hospital,Yinchuan,Ningxia 750002,China
- 折叠
摘要
Abstract
Objective To explore the clinical effect of endoscopic sphincterotomy(EST)combined with 12 mm large balloon dilation(LBD)in the treatment of choledocholithiasis,and to analyze the impact of dilation time on postoperative complication.Methods Clinical data of 164 patients with common bile duct stones who underwent EST-LBD at Ningxia Hui Autonomous Region People's Hospital from January 2021 to May 2024 were prospectively collected.Using a single-blind method,the patients were randomly assigned to either the 30 s group(n=82)or the 300 s group(n=82).The stone retrieval outcomes,short-term complications including post-endoscopic retrograde cholangiopancreatography pancreatitis(PEP),postoperative bleeding,acute cholangitis,and gastrointestinal perforation,as well as long-term complication rates including acute cholangitis and stone recurrence within 12 months postoperatively were compared between the two groups using Pearson's chi-square test or the continuous correction chi-square test.Results No statistically significant differences were observed between the 30 s and 300 s groups in one-time stone retrieval success rate[91.5％(75/82)vs 95.1％(78/82),P>0.05]or the mechanical lithotripsy rate[19.5％(16/82)vs 17.1％(14/82),P>0.05].However,the incidence of PEP in the 30 s group was significantly higher than that in the 300 s group[18.3％(15/82)vs 7.3％(6/82),P<0.05].The incidence of postoperative acute cholangitis[7.3％(6/82)vs 9.8％(8/82)]showed no significant difference(P>0.05).Postoperative bleeding occurred in one patient in the 30 s group,while no bleeding occurred in the 300 s group.No cases of gastrointestinal perforation were reported in either group.During the 12-month follow-up,no significant differences were found in the incidence of acute cholangitis[7.6％(6/79)vs 10.0％(8/80)]or stone recurrence rate[6.3％(5/79)vs 7.5％(6/80)]between the two groups(both P>0.05).Conclusion For patients with common bile duct stones undergoing EST-LBD with 12 mm large balloon,a dilation duration of 300 seconds is associated with a significantly lower risk of PEP compared to a duration of 30 seconds.The dilation duration has minimal impact on the incidence of other complications,including acute cholangitis,postoperative bleeding,gastrointestinal perforation,and long-term stone recurrence.关键词
胆总管结石/内镜下十二指肠乳头括约肌切开/内镜下球囊扩张术/内镜逆行胆胰管造影(ERCP)/ERCP术后胰腺炎Key words
choledocholithiasis/endoscopic sphincterotomy/endoscopic papillary balloon dilation/endoscopic retrograde cholangiopancreatography(ERCP)/post-ERCP pancreatitis分类
医药卫生
