[1]禹雪,王玲,王丹丹,等.内镜下Oddi括约肌切开术治疗肝内外胆管结石病的疗效分析[J].中国微创外科杂志,2018,18(1):20-32.
　Yu Xue,Wang Ling,Wang Dandan,et al.Evaluation on Endoscopic Oddi Sphincterotomy for Intra- and Extra-hepatic Stones[J].Chinese Journal of Minimally Invasive Surgery,2018,18(1):20-32.
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内镜下Oddi括约肌切开术治疗肝内外胆管结石病的疗效分析()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
18
期数:
2018年1期
页码:
20-32
栏目:
临床研究
出版日期:
2018-03-21

文章信息/Info

Title:
Evaluation on Endoscopic Oddi Sphincterotomy for Intra- and Extra-hepatic Stones
作者:
禹雪; 王玲; 王丹丹; 杨亚兵; 马浚仁; 徐智; 侯纯升; 王立新; 凌晓锋**
北京大学第三医院普通外科，北京100191
Author(s):
Yu Xue;  Wang Ling;  Wang Dandan;  et al.
Department of General Surgery, Peking University Third Hospital, Beijing 100191, China
关键词:
肝内胆管结石病; 内镜下Oddi括约肌切开术
Keywords:
Hepatolithiasis; Endoscopic sphincterotomy
文献标志码:
A
摘要:
目的探讨内镜下Oddi括约肌切开术（endoscopic sphincterotomy，EST）治疗肝内外胆管结石病的疗效。方法回顾性分析我院2005年1月~2015年12月28例EST治疗肝内外胆管结石病的临床资料，EST治疗前胆管炎发作27例，仅腹痛发作1例。随访EST治疗后胆管炎的发生率及临床转归。结果EST后8例结石取净，残余结石20例。合并肝内、外胆管狭窄10例，其中2例置入胆道支架。EST治疗后胆管炎发作25例，复发率89.3%（25/28），12例再次行EST治疗，13例行开腹手术。全组治疗后18例无胆管炎发作，胆管炎复发5例，腹部不适1例，死亡4例。结论EST治疗肝内胆管结石病残余结石率高，胆管炎复发率高，无法彻底矫正狭窄的胆管，部分患者仍然需要手术治疗，因此EST不宜作为肝内胆管结石病的主要治疗措施。
Abstract:
ObjectiveTo evaluate the effect of endoscopic sphincterotomy (EST) for intra- and extra-hepatic stones.MethodsClinical materials of 28 patients with intra- and extra-hepatic stones undergoing EST in our hospital from January 2005 to December 2015 were reviewed retrospectively. There were 27 cases of cholangitis and 1 case of abdominal pain. The cholangitis rate and clinical outcomes after EST were followed up.ResultsThe stones were completely cleared in 8 patients and residual stones existed in 20 patients. Complicated intrahepatic and extrahepatic bile duct stricture occurred in 10 cases, two of which were given stent implantation. After EST there were 25 cases of recurrent cholangitis (25/28, 89.3%). Twelve patients received EST again and 13 patients underwent open operations. Finally, 18 patients were asymptomatic, as compared with 5 patients suffering from cholangitis, 1 patient with abdominal pain and 4 patients fatal.ConclusionsEST has a high residual stone rate and a high recurrent cholangitis rate for hepatolithiasis. It can not correct biliary stricture radically. Most cases of hepatolithiasis receiving EST have to receive surgery. Therefore, EST is not an optimal and definitive procedure for hepatolithiasis.

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备注/Memo

备注/Memo:
基金项目：北京市自然科学基金（7172233）**通讯作者，E-mail：xiaofengling2005@126.com
更新日期/Last Update: 2018-03-21