胆总管巨大结石内镜下治疗效果的评价

目的探讨胆总管巨大结石内镜下分次取石治疗的临床效果。方法183例胆总管结石大于1.5 cm的患者,在内镜下按照机械碎石、网篮和气囊取石、胆管引流(鼻胆管、塑料支架)等方法进行胆管内取石,记录乳头肌切开的大小、结石大小与碎石、取石次数和并发症。结果胆总管结石越大所需碎石、取石的次数越多,需要置放胆管引流的患者越多,需要外科手术的患者也多,但其他并发症未见明显增多。结论胆总管巨大结石内镜下分次治疗的方法是安全的、可靠的。

THE ASSESSMENT OF CLINICAL EFFICIENCY OF REMOVING HUGE COMMON BILE DUCT STONES BY ENDOSCOPY

Objective To evaluate the clinical efficiency of stepwisely removing huge common bile duct stones by endoscopic treantment(ERCP and EST).Motheds 183 patients with common bile duct stones no less than 1.5 cm were selected to take the endoscopic treatment,such as mechanical lithotripsy,removing stones by basketnet with/or balloon,and bile duct drainage(endoscopic nasobiliary drainage,Teflon plastic stents).The size of the dissected papillary muscle and diameters of the calculus,the times of the operation and the complications caused by ERCP and EST were recorded.Results While the size of the calculus is bigger,the times of removing stone increased and bile duct drainage and surgical intervention were more needed.However,other complications didn′t rise apparently.Conclusion Removing the common bile duct stones step by step by endoscopic treatment(ERCP and EST,lithotripsy,etc) is efficient,safe and reliable.