外科理论与实践2026，Vol.31Issue(4)：326-334,9.DOI:10.16139/j.1007-9610.2026.04.07
置入胰管支架对ERCP取石联合ERBD术后肝外胆管结石复发的影响因素分析
Analysis of influencing factors of placement of pancreatic duct stent on recurrence of extrahepatic bile duct stones after ERCP lithotomy combined with ERBD
王玉彬 1张红雷 2张诚 2孔祥余 2项羽凯 2杨玉龙1
作者信息
- 1. 同济大学医学院,上海 200331
- 2. 同济大学附属东方医院胆石病中心,上海 200120
- 折叠
摘要
Abstract
Objective To investigate the impact of pancreatic duct stent on long-term recurrence of extrahepatic bile duct stones after endoscopic retrograde cholangiopancreatography(ERCP)lithotomy combined with endoscopic retrograde biliary drainage(ERBD),and to provide clinical reference for treating patients with extrahepatic bile duct stones and preventing stone recurrence.Methods A total of 366 patients with extrahepatic bile duct stones treated by ERCP lithotomy and ERBD between April 2019 and August 2024 were enrolled and followed up.The patients were divided into a research group and a control group according to whether received ERPD.Recurrence outcomes were collected and compared between the two groups.Propensity score matching(PSM)was used to eliminate confounding bias,followed by Kaplan-Meier survival curve generation.COX regression analysis was performed to analyze the influencing factors.Results A total of 366 patients were included,with a median follow-up duration of 13.8(6.2,29.8)months.Thirteen cases(3.6％)developed recurrence.After PSM,the Kaplan-Meier survival curve showed the recurrence risk of the research group was significantly reduced(HR=0.092,95％CI:0.012-0.716,P=0.004).COX regression analysis revealed that duodenal papilla length>8 mm(HR=4.04,95％CI:1.13-14.45,P=0.032),stone type(HR=0.10,95％CI:0.01-0.85,P=0.035),and ERPD(HR=0.04,95％CI:0.00-0.72,P=0.029)were independent influencing factors.Conclusions ERPD is an independent protective factor against long-term recurrence of extrahepatic bile duct stones after ERCP lithotomy and ERBD.A duodenal papilla length>8 mm is an independent risk factor.Block extrahepatic bile duct stones have a lower long-term recurrence risk than silt-like stones.关键词
肝外胆管结石/内镜逆行胰胆管造影/胰管支架/胆管支架/结石复发Key words
Extrahepatic bile duct stone/Endoscopic retrograde cholangiopancreatograph(ERCP)/Pancreatic duct stent/Biliary stent/Stone recurrence分类
医药卫生引用本文复制引用
王玉彬,张红雷,张诚,孔祥余,项羽凯,杨玉龙..置入胰管支架对ERCP取石联合ERBD术后肝外胆管结石复发的影响因素分析[J].外科理论与实践,2026,31(4):326-334,9.
