经内镜乳头括约肌切开术及经内镜乳头气囊扩张术治疗肝外胆.doc

经内镜乳头括约肌切开术与经内镜乳头气囊扩张术治疗肝外胆管结石的临床比较 胡贯中1，金震东2，刘 枫2，张敏敏2，王 东2，王洛伟2，施新岗2，陈 洁2，李兆申2，邹多武2* 1.复旦大学校医院内科，上海 200433 2.第二军医大学长海医院消化内科，上海 200433 [作者简介] 胡贯中，硕士生，主治医师．E-mail：huguanzhong8@163.com Corresponding author)．Tel：021E-mail：duowuzou@ EST)与经内镜乳头气囊扩张术(EPBD)在治疗肝外胆管结石方面的异同。方法 回顾性分析上海长海医院消化内科2009年82011年7月277,其中行EST的168EPBD的109EST组和EPBDEST组结石直径为(11.3+6.2)mm，EPBD组结石直径为(10.1+5.7)mm，两者差异无统计学意义(P=0.1056)；EST组和EPBD组EST组手术操作时间平均为(21.2+3.1)min，EPBD组手术操作时间平均为(20.7+2.5)min，两者差异无统计学意义(P=0.1591)；EST组结石一次取净率为95.2%，与EPBD组的94.5%（P=0.7828）EST组为（4.1+1.9）dEPBD组为（4.1+2.0）d，P=1.0000)；EST组近期并发症总发生率为10.1%，EPBD组为12.8%P=0.4822)，EST组中出血的发生率为3.6%，EPBD组为0P0.05)；EPBD组8.3%，EST组为2.4%，两者之间的差异具有统计学意义(P0.05)。结论 EST和EPBDR575.7 Comparison of endoscopic sphincterotomy and endoscopic papillary balloon dilation in the treatment of extrahepatic bile duct stones HU Guan-zhong1，JIN Zhen-dong2，LIU Feng2，ZHANG Min-min2，WANG Dong2，WANG Luo-wei2，SHI Xin-gang2，CHEN Jie2，LI Zhao-shen2，ZOU Duo-wu2* 1.Department of Internal medicine，Fudan University Hospital，Shanghai 200433，China 2.Department of Gastroenterology，Changhai Hospital，Second Military Medical University，Shanghai 200433，China ［Abstract］ Objective To compare endoscopic sphincterotomy ( EST ) and endoscopic papillary balloon dilation ( EPBD ) in the treatment of extrahepatic bile duct stones in terms of similarities and differences. Methods Clinical data of 277 patients with extrahepatic bile duct stones from August 2009 to July 2011 in gastroenterology department of Shanghai Changhai Hospital were retrospectively analyzed. 168 of the 277 patients received EST and the other 109 received EPBD.The general case, stone diameter, stone extraction method, operation time, stone once complete clearance rate, postoperative hospital stay and short-term complications of EST group and EPBD group were compared. Results There was no statistic difference in the age, sex ratio, combined duodenal diverticulum between two groups .The stone diameter was (11.3+