内镜下十二指肠乳头括约肌切开术治疗胆总管结石697例临床分析

目的 总结内镜下十二指肠乳头括约肌切开术治疗胆总管结石的疗效及并发症的处理经验。方法 回顾性总结了我院5年间经内镜十二指肠乳头括约肌切开术（EST）治疗胆总管结石697例的临床资料，分析临床应用的疗效及并发症的发生情况、种类、处理及预防的措施。结果 5年间697例EST取石术成功682例，成功率97．8％，并发急性胰腺炎25例（3．6％），消化道穿孔3例（0．43％），延迟出血5例（0．72％），术后胆管炎5例（0．72％），经内科保守治愈30例，外科手术治疗4例，内镜再次处理4例。结论 内镜下十二指肠乳头括约肌切开术治疗胆总管结石安全可行。熟练的内镜外科技术和丰富的开腹手术经验是完成此治疗的关键。

Endoscopic papillosphincterotomy for choledocholith: an analysis of 697 cases

Objective To summarize the experience in treatment of choledocholith by endoscopic papillosphincterotomy.Methods The clinical data of 697 patients with choledocholith receiving endo- scopic papillosphincterotomy from December 1998 to December 2003 in our hospital were retrospec- tively analyzed.Results Endoscopic papillosphincterotomy was successfully completed in 682 patients (97.8%).Postoperative complications occurred in 38 patients(including acute pancreatitis in 25,di- gestive tract perforation in 3,delayed hemorrhage in 5 and cholangitis in 5).Of the 38 patients,30 underwent conservative treatment,4 surgical therapy and 4 endoscopic management again.Conclusions Endoscopic papillosphincterotomy is feasible and safe for treatment of choledocholith.In order to smoothly accomplish the operation,it is crucial that the procedure should be performed by skillful sur- geons.