肝胆胰外科杂志2026，Vol.38Issue(10)：699-705,7.DOI:10.11952/j.issn.1007-1954.2026.10.002
快速交换双向注射取石球囊在ERCP取石中的应用研究
Application of rapid exchange bidirectional injection stone extraction balloon in ERCP stone extraction
摘要
Abstract
Objective To compare the efficacy difference of the rapid exchange bidirectional injection stone extraction balloon and the ordinary stone extraction balloon in endoscopic retrograde cholangiopancreatography(ERCP)stone extraction.Methods A rapid exchange bidirectional injection stone extraction balloon has been designed by our research group.The sheath of the stone extraction balloon has a guidewire channel,a balloon channel,and a contrast channel.The proximal wall of the balloon catheter has a guidewire side hole connected to the guidewire channel,which can be quickly exchanged under the guidance of the guidewire.It has both functions of injecting contrast agent above the balloon and below the balloon.The clinical data of 185 patients who underwent ERCP for common bile duct stones in East Hospital Affiliated to Tongji University and the Second Hospital of Dalian Medical University between April 2026 and May 2026 were retrospectively analyzed.According to the types of stone extraction balloon used in ERCP,patients were divided into an observational group(rapid exchange bidirectional injection stone extraction balloon,n=69)and a control group(ordinary stone extraction balloon,n=116).The rate of guidewire displacement,rate of guidewire detachment,time for balloon catheter exchange,time for X-ray irradiation,time for balloon stone extraction,satisfaction score for choledochal visualization,times for balloon stone extraction,rates of postoperative cholangitis and residual stones were compared between the two groups.Results The rates of guidewire displacement[17.39%(12/69)vs 73.28%(85/116),χ2=54.176,P<0.001]and guidewire detachment[0 vs 7.76%(9/116),χ2=5.627,P=0.018]in the observational group were lower than those in the control group.The time for balloon catheter exchange[(23.68±2.14)s vs(41.97±1.93)s,t=− 59.854,P<0.001],for X-ray irradiation[(22.91±5.90)s vs(34.52±9.05)s,t=− 9.512,P<0.001]and for balloon stone extraction[(61.60±23.72)s vs(149.78±18.07)s,t=−28.394,P<0.001]were shorter than those in the control group.The satisfaction score for choledochal visualization in the observational group was higher than that in the control group[(8.81±1.58)vs(7.91±1.38),t=4.047,P<0.001].The frequency of balloon stone extraction in the observational group was less than that in the control group[2(1,2)vs 3(2,3),Z=− 9.292,P<0.001].The rates of postoperative cholangitis[5.80%(4/69)vs 12.07%(14/116),χ2=1.938,P=0.164]and residual stones[8.70%(6/69)vs 12.93%(15/116),χ2=0.771,P=0.380]showed no statistically significant difference between the two groups.Conclusion The application of a rapid exchange bidirectional injection stone extraction balloon during ERCP lithotomy demonstrates favorable clinical outcomes.Compared with ordinary stone extraction balloon,the rapid exchange bidirectional injection stone extraction balloon has shorter balloon catheter exchange time,lower guidewire displacement and detachment rates,and higher choledochal visualization satisfaction score.It can reduce the times for balloon stone extraction,shorten the time for X-ray irradiation and stone extraction while ensuring a low rate of residual stone.关键词
胆总管结石/内镜逆行胰胆管造影/取石球囊/快速交换/双向注射Key words
common bile duct stone/endoscopic retrograde cholangiopancreatography/stone extraction balloon/rapid exchange/bidirectional injection分类
医药卫生引用本文复制引用
张诚,杨玉龙,何川琦,祁春春,张桂信..快速交换双向注射取石球囊在ERCP取石中的应用研究[J].肝胆胰外科杂志,2026,38(10):699-705,7.基金项目
上海市浦东新区卫生系统重点专科项目(PWZzk2022-17). （PWZzk2022-17）
