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中华介入放射学电子杂志 ›› 2016, Vol. 04 ›› Issue (02) : 63 -66. doi: 10.3877/cma.j.issn.2095-5782.2016.02.002

所属专题: 文献

非血管介入

两种途径球囊扩张术治疗胆总管结石的临床效果比较
吕朋华1, 王立富1, 邓登豪2, 王书祥1, 孙陵1, 刘军2, 蔡明玉1, 耿素萍1, 黄文诺1   
  1. 1. 225001 江苏省苏北人民医院,扬州大学临床医学院介入放射科
    2. 225001 江苏省苏北人民医院,扬州大学临床医学院消化内科
  • 收稿日期:2016-02-20 出版日期:2016-05-01

Balloon dilatation treating common bile duct stones: comparison of two methods

Penghua Lyu1, Lifu Wang1, Denghao Deng2, Shuxiang Wang1, Ling Sun1, Jun Liu2, Ming yu Cai1, Suping Geng1, Wennou Huang1   

  1. 1. Department of Interventional Radiology, Northern Jiangsu people's hospital, Clinical Medical school and Affiliated hospital to Yangzhou university, Yangzhou 225001, China
    2. Department of Gastroenterology, Northern Jiangsu people's hospital, Clinical Medical school and Affiliated hospital to Yangzhou university, Yangzhou 225001, China
  • Received:2016-02-20 Published:2016-05-01
引用本文:

吕朋华, 王立富, 邓登豪, 王书祥, 孙陵, 刘军, 蔡明玉, 耿素萍, 黄文诺. 两种途径球囊扩张术治疗胆总管结石的临床效果比较[J/OL]. 中华介入放射学电子杂志, 2016, 04(02): 63-66.

Penghua Lyu, Lifu Wang, Denghao Deng, Shuxiang Wang, Ling Sun, Jun Liu, Ming yu Cai, Suping Geng, Wennou Huang. Balloon dilatation treating common bile duct stones: comparison of two methods[J/OL]. Chinese Journal of Interventional Radiology(Electronic Edition), 2016, 04(02): 63-66.

目的:

比较经皮经肝球囊扩张和内镜下球囊扩张术治疗胆总管结石的临床效果。

方法:

自2013年1月—2015年1月,25例胆总管结石患者采用经皮经肝途径取石,纳入A组。选取同期经内镜途径球囊扩张术治疗的60例胆总管结石患者,纳入B组。

结果:

A组胆总管结石取净率为100%,B组为96.7%,差异无统计学意义(P=1.000);A组近期并发症发生率12%(3/25),B组10%(6/60),两组差异无统计学意义(校正χ2=0.073,P>0.05),B组发生2例胰腺炎,A组发生1例肝脓肿。A组平均手术时间(50±8) min,长于B组(39±6) min。随访1年,A组有1例患者胆总管结石复发,B组发生1例返流性胆管炎。

结论:

经皮经肝胆途径取石具有与内镜下球囊扩张术取石相同的手术成功率以及较低的并发症发生率,可以作为不适合内镜治疗或者内镜治疗失败的胆总管结石患者的治疗措施。

Objective:

This study is to compare the clinical efficacy of percutaneous transhepatic balloon dilatation(PTBD)and endoscopic papillary balloon dilatation(EPBD) in treating common bile duct(CBD)stones.

Methods:

Between January 2013 and January 2015,a comparison study was conducted among 25 patients with CBD stones who underwent PTBD treatment and were listed in Group A while 60 patients who underwent EPBD treatment and were listed in Group B.

Results:

Clearance of CBD stones in Group A patients was 100% ,and 96.7% in group B (P=1.000), with no significant statistical difference. The average time of the procedure was (50±8) minutes and (39±6) minutes, respectively. The short-term incidence of complications in group A was 12%(3/25),and 10%(6/60)in Group B(P>0.05). However,one hepatic abscess occurred in group A and two cases of pancreatitis occurred in group B. A one-year follow-up study demonstrated one gallstone recurrence in group A and one cholangitis in group B.

Conclusions:

Percutaneous transhepatic removal of CBD stones has a high success rate with low complications . It is an effective alternative strategy for CBD treatment, especially when endoscopic procedure fails or is not feasible.

表1 2组患者的临床资料
图1 PTBD途径结石取出术。A:胆道穿刺造影见胆总管中段两枚结石(箭头所示)。B:柱状球囊扩张十二指肠乳头。C:取石球囊推送结石。D:胆总管结石顺利推送入肠道。
表1 2组患者并发症的发生情况
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