关键词: 胆道支架内引流, 胆总管结石, 内镜下十二指肠乳头切开

Abstract:

 Objective To investigate the clinical value of combination of limited endoscopic sphincterotomy （limited EST） and endoscopic retrograde bilioduodenal drainage （ERBD） in the treat-ment of refractory common bile duct stones. Methods Forty-eight cases with common bile duct stones were assigned to observation group （n=25）in which the patients were performed limited EST + ERBD, and control group（n=23）, the patients underwent ERBD alone. All the 48 patients were treated with 8.5 Fr biliary plastic stent drainage. The degree of abdominal pain, fever, white blood cells, amylase, lipase and other related index were observed at one week after operation were recorded. Liver function-related indicators and the condition of common bile duct stones were observed at one, three and six months after operation. The safety and effectiveness of limited EST+ERBD were evaluated. Results The treatment both limited EST plus ERBD and ERBD alone gained a significant effect on symptom relief. None of bleeding, perforation and other serious complications occurred in follow-up. The Results both group at 1 month and 3 months after operation were similar （all P values less than 0.05）in recorded indexes. However, the observation group had better outcomes after 6 months. Conclusion Limited EST + ERBD is a safe and effective transition therapy for refractory common bile duct stones, and it will win time for the next treatment.

Key words: common bile duct stones, endoscopic retrograde bilioduodenal drainage, endoscopic sphincterotomy