摘要
目的 探讨内镜下十二指肠乳头括约肌切开术（EST）治疗胆总管结石患者的远期治疗效果,评估EST术后胆囊切除的必要性.方法 对2006年1月至12月因胆总管结石而行EST治疗257例患者进行随访,所有患者平均随访时间为34.8个月（26～48个月）.根据不同病情和处理情况分为3组进行比较,合并有胆囊结石的患者EST术后行胆囊切除为A1组,EST术后未行胆囊切除为A2组;B组为未合并胆囊结石者.结果 出现远期并发症者31例（12.1%）,胆总管结石复发25例（9.7%）,胆管炎27例（10.1%）,胰腺炎2例（0.8%）,胆管癌1例（0.4%）;A2组患者远期并发症发生率、胆总管结石复发率均高于A1组（P均〈0.05）.结论 从远期疗效来看,EST是治疗胆总管结石的安全、有效的方法,对于合并有胆囊结石的患者EST术后行胆囊切除是有必要的.
Objective To explore the long-term efficacy of endoscopic sphincterotomy （EST） for choledocholithiasis and to evaluate the necessity of cholecystectomy after EST. Methods Two hundred and fifty seven patients who underwent EST for choledocholithiasis in 2006 were followed up for an average period of 34. 8 months （26-48 months）. According to the existence of cholecystolithiasis, the patients were divided into group A （combined with cholecystolithiasis, n = 151） and group B （without cholecystolithiasis, n = 106） , and group A was further divided into group A1 as undergoing cholecystectomy after EST （n =56） and group A2 as not having cholecystectomy after EST （ n = 95）. Results Of the 257 patients, late complications occurred in 31 patients （12. 1% ） , including recurrent choledocholithiasis in 25 （9.7% ）, cholangitis in 27 （10. 1% ） , acute pancreatitis in 2 （0. 8% ） and cholangiocarcinoma in 1 （0.4% ）. The rates of late complications and recurrent choledocholithiasis were significantly higher in group A2 than those in group A1 （P〈0.05）. Conclusion EST is safe and effective for choledocholithiasis. Cholecystectomy after EST is necessary in patients with cholecystolithiasis.
出处
《中华消化内镜杂志》
北大核心
2010年第7期353-355,共3页
Chinese Journal of Digestive Endoscopy
关键词
类癌瘤
直肠
内镜黏膜切除术
Carcinoid tumor
Rectum
Endoscopic mucosal resection
