ESPBD与EST治疗肝硬化合并胆总管结石患者疗效比较*

doi:10.3969/j.issn.1672-5069.2023.06.037

Abstract

Abstract: Objective The aim of this study was to investigate the efficacy of limited endoscopic sphincterotomy with balloon dilation (ESPBD) and endoscopic sphincterotomy (EST) in the treatment of patients with liver cirrhosis common bile duct stones. Methods 112 patients with compensated liver cirrhosis and choledolithiasis were admitted to our hospital between March 2018 and March 2022, and 56 patients in the control were treated with EST and another 56 in the observation group were treated with ESPBD. Serum cortisol (COR), norepinephrine (NE) and epinephrine (E) levels were detected by ELISA. Results The successful rate of one time stone removal in the observation group was 96.4%, significantly higher than 80.4% in the control group (P <0.05); the intra-operational blood loss, operation time, exhaust time and hospital stay in the observation group were(25.3±3.1)mL, 41.8±5.1)min, (24.3±4.6)h and (8.1±1.6)d, not significantly different compared to [(27.9±2.8)mL, (44.9±4.9)min, (25.7±6.9)h and (7.8±2.1)d] in the control (P>0.05); 7 day after operation, total serum bilirubin, serum alanine aminotransferase, albumin and glutamyl transpeptidease levels in the observation were (15.4±3.6)μmol/L, (29.6±5.7)U/L, (36.3±6.9)g/L and (94.2±5.2)U/L, not significantly different compared to (14.8±2.9)μmol/L, (30.2±6.8)U/L, (37.1±5.8)g/L and (96.1±6.3)U/L in the control (P＞0.05); serum COR, NE and E levels were (129.7±18.2)pg/mL, (415.1±51.6)pg/mL and (24.4±3.9)pg/mL, not significantly different compared to (135.9±21.6)pg/mL,(422.7±53.9)pg/mL and (25.9±4.1)pg/mL in the control (P>0.05); post-operationally, the incidence of complications, such as infection, pancreatitis, intraperitoneal bleeding, bile leak and hyperamylasemia in the observation was 14.3%, much lower than 30.4%(P＜0.05) in the control group. Conclusion Compared with EST treatment, the application of ESPBD in the treatment of patients with liver cirrhosis and choledocholithiasis is efficacious with high one-time successful rate of stone removal and less postoperative complications.

Key words: Choledocholithiasis, Liver cirrhosis, Limited endoscopic sphincterotomy with balloon dilation, Endoscopic sphincterotomy, Therapy

Liu Ming, Wang Jinting, Yang ShiYan, et al. Efficacy comparison of ESPBD and EST in the treatment of compensated liver cirrhotics with choledocholithiasis[J]. Journal of Practical Hepatology, 2023, 26(6): 915-918.

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Efficacy comparison of ESPBD and EST in the treatment of compensated liver cirrhotics with choledocholithiasis

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