肝胆胰外科杂志2026，Vol.38Issue(3)：195-200,6.DOI:10.11952/j.issn.1007-1954.2026.03.006
内镜下乳头球囊扩张对比十二指肠乳头括约肌小切开联合球囊扩张治疗中等大小胆总管结石的效果分析
Comparison of endoscopic papillary balloon dilation versus small endoscopic sphincterotomy plus balloon dilatation in the treatment of medium-sized common bile duct stones
摘要
Abstract
Objective To compare the clinical efficacy of endoscopic papillary balloon dilation(EPBD)versus small endoscopic sphincterotomy plus balloon dilatation(ESBD)under endoscopic retrograde cholangiopancreatography(ERCP)in the treatment of medium-sized common bile duct stones.Methods This study retrospectively analyzed the clinical data of 806 patients with simple medium-sized(8 to 12 mm)common bile duct stones,who were treated at People's Hospital of Xiangxi Autonomous Prefecture(n=398)and Zhangjiajie People's Hospital(n=408)between January 2020 and January 2024.According to the different treatment methods,the 806 patients were divided into the EPBD group(n=401)and the ESBD group(n=405).The one-time stone clearance rate,success rate of stone removal,time of hospital stay,hospitalization cost,and postoperative complication were compared between the two groups.Results There was no statistically significant difference in terms of one-time stone clearance rate(99.3%vs 97.5%)or success rate of stone removal(99.8%vs 99.3%)between the EPBD group and the ESBD group(P>0.05).The EPBD group had significantly shorter time of hospital stay[(14.5±3.5)d vs(15.5±4.5)d,t=-3.519,P<0.001]and lower hospitalization cost[(2.25±0.54)ten thousand CNY vs(2.67±0.57)ten thousand CNY,t=-10.737,P<0.001]than those of the ESBD group.Postoperative day 3,the liver function(total bilirubin,direct bilirubin,alanine aminotransferase)and infection condition(white blood cell count,C-reactive protein,procalcitonin)in both groups were significantly improved(P<0.05),but there was no statistically significant difference between the groups(P>0.05).Compared with the ESBD group,the incidence of postoperative hyperamylasemia in the EPBD group was significantly higher(14.7%vs 9.9%,χ2=3.938,P=0.047),but the incidence of postoperative bleeding was significantly lower(0 vs 1.5%,P=0.031).There was no statistically significant difference in the postoperative pancreatitis(4.7%vs 4.4%,χ2=0.001,P=0.975)or total postoperative complication(19.7%vs 16.5%,χ2=1.150,P=0.284)between the EPBD group and the ESBD group.No severe complication or death occurred in either group.Conclusion The efficacy of EPBD for treatment of medium-sized common bile duct stones is comparable to that of ESBD,and EPBD results in less postoperative bleeding,shorter time of hospital stay,and lower treatment cost.关键词
胆总管结石/内镜逆行胰胆管造影/内镜下乳头球囊扩张/内镜下十二指肠乳头括约肌切开Key words
common bile duct stones/endoscopic retrograde cholangiopancreatography/endoscopic papillary balloon dilation/endoscopic sphincterotomy分类
医药卫生引用本文复制引用
周国超,付华,蔡融民,杨定华,宋新,杨康..内镜下乳头球囊扩张对比十二指肠乳头括约肌小切开联合球囊扩张治疗中等大小胆总管结石的效果分析[J].肝胆胰外科杂志,2026,38(3):195-200,6.基金项目
湖南省自然区域联合基金(2024JJ7557) （2024JJ7557）
湖南省卫健委科研项目(202204014693). （202204014693）
