关键词: 肝外胆管结石, 十二指肠镜下乳头括约肌切开术, 十二指肠镜下乳头气囊扩张术, 治疗

Abstract: Objective To explore the clinical application of endoscopic sphincterotomy （EST） combined with endoscopic papillary balloon dilatation （EPBD） in the treatment of patients with extrahepatic bile duct stones without bile duct dilation. Methods The clinical data of 124 bile duct stone patients with non-dilated extrahepatic bile duct were retrospectively analyzed,and patients in combined underwent EST combined with EPBD （n=49）,in observation underwent EST alone（n=31） and in control group received conventional choledochotomy plus T-tube drainage（n=44）. Results At the end 48 h after operation,serum amylase （AMS） level in combination group was （107.1±34.6） U/L,and hypersensitivity C-reactive protein （hsCRP） level was （37.2±8.9） mg/L,those in observation group were （113.9±35.2） U/L and （38.1±9.4） mg/L,both significantly lower than （221.5±54.8） U/L and （73.2±16.2） mg/L,respectively（P<0.05） in the control;the operation duration in combination group was （95.2±14.8） min,and it in observation group was （113.6±12.7） min,both longer than [（84.8±12.1）,P<0.05] in the control;the incidence rates of pancreatitis and reflux cholangitis in combined group were 2.0% and 4.1%,significantly lower than 19.4% and 22.6% in observation group or 18.2% and 22.7% （P<0.05） in the control. Conclusions The application of EST and EPBD combination is efficacious approach in dealing with patients with choledocholithiasis without extrahepatic bile duct dilation,which might improve fast postoperative recovery,and reduce the short-term and long-term complications.

Key words: Choledocholithiasis, Endoscopic sphincterotomy, Endoscopic papillary balloon dilatation, Therapy