中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Menu
Issue 2
Feb.  2018
Turn off MathJax
Article Contents
Abstract
References
Article Navigation >  Journal of Clinical Hepatology  > 2018  >  34(2): 341-345

Efficacy and safety of minor endoscopic sphincterotomy combined with endoscopic papillary large balloon dilation in treatment of elderly patients with multiple large common bile duct stones

DOI: 10.3969/j.issn.1001-5256.2018.02.024

  • Department of Digestive Diseases, Ankang Municipal Central Hospital Affiliated to Hubei Medical College

  • Published Date: 2018-02-20
    Abstract

  • Objective To investigate the clinical effect and safety of minor endoscopic sphincterotomy (m EST) combined with endoscopic papillary large balloon dilation (EPLBD) in the treatment of elderly patients with multiple large common bile duct stones.Methods A retrospective analysis was performed for 229 patients with multiple large common bile duct stones who underwent endoscopic retrograde cholangiopancreatography (ERCP) in Endoscopy Center, Ankang Municipal Central Hospital, from January 2012 to December 2016, and the surgical procedure was selected based on the size of stones and the morphology of the common bile duct.According to the endoscopic surgical procedure, the patients were divided into m EST + EPLBD group (treatment group with 136 patients) and endoscopic phincterotomy (EST) group (control group with 93 patients) .The two groups were compared in terms of the success rate of first stone removal, use rate of mechanical lithotripsy (ML) , time spent on stone removal, and the incidence rate of complications.The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups.Results There was no significant difference in the success rate of first stone removal between the treatment group and the control group (91.17% vs 87.10%, χ2=0.980, P > 0.05) , while there were significant differences in the time spent on stone removal (18.2 ± 4.3 min vs 37.4 ± 6.7 min, χ2=37.1526, P < 0.01) and use rate of ML (6.71% vs 40.00%, t = 24.411, P < 0.01) .There were no significant differences in the incidence rates of pancreatitis (2.94% vs 6.45%, χ2= 1.630, P > 0.05) and bleeding (2.21% vs 2.15%, χ2= 0.001, P > 0.05) between the two groups, and no patient experienced perforation or infection.Conclusion m EST + EPLBD has a good clinical effect in the treatment of elderly patients with multiple large common bile duct stones and can effectively shorten the time spent on stone removal, reduce the use rate of ML, and thus reduce the recurrence rate of stones.In addition, this method does not increase post-ERCP complications and is a safe and effective therapeutic method for multiple large common bile duct stones in elderly patients.

     

    • FullText(HTML)
    • References(18)
  • [1]KAWAI K, AKASAKA Y, MURAKAMI K, et al.Endoscopic sphincterotomy of the ampulla of Vater[J].Gastrointest Endosc, 1974, 20 (4) :148-151.
    [2]NIE ZG, DAI ZM.Features and strategies of endoscopic retrograde cholangiopancreatography in elderly patients aged above 60 years with biliary and pancreatic diseases[J].J Clin Hepatol, 2017, 33 (4) :656-660. (in Chinees) 聂占国, 代忠明.经内镜逆行胰胆管造影治疗60岁以上老年胆胰疾病患者的特点及策略[J].临床肝胆病杂志, 2017, 33 (4) :656-660.
    [3]WEI L, WANG CQ, LIU Z.Safety and efficacy of therapeutic endoscopic retrograde cholangiopancreatography in very elderly patients (85 years or older) with common bile duct stones[J].J Clin Hepatol, 2015, 31 (10) :1637-1640. (in Chinese) 韦璐, 王长青, 刘政.经内镜逆行胰胆管造影治疗85岁以上胆总管结石患者的效果观察[J].临床肝胆病杂志, 2015, 31 (10) :1637-1640.
    [4]YOO KS, LEHMAN GA.Endoscopic management of biliary ductal stones[J].Gastroenterol Clin North Am, 2010, 39 (2) :209-227.
    [5] LIU JZ, REN Z, QIN WZ, et al.Clinical effect of endoscopic retrograde cholangiopancreatography for elderly patients with periampullary diverticula accompanied with choledocholithiasis[J].Chin J Dig Surg, 2017, 16 (4) :380-384. (in Chinese) 刘靖正, 任重, 秦文政, 等.内镜逆行胰胆管造影取石治疗老龄壶腹周围憩室伴发胆总管结石病患者的临床疗效[J].中华消化外科杂志, 2017, 16 (4) :380-384.
    [6]MCHENRY L, LEHMAN G.Difficult bile duct stones[J].Curr Treat Options Gastroenterol, 2006, 9 (2) :123-132.
    [7]COTTON PB, LEHMAN G, VENNES J, et al.Endoscopic sphincterotomy complications and their management:an attempt at consensus[J].Gastrointest Endosc, 1991, 37 (3) :383-393.
    [8]LIU MY, SUN MJ.Emergency ERCP in the management of acute obstructive cholangitis and biliary pancreatitis[J].Chin J Med Offic, 2017, 45 (5) :504-507. (in Chinese) 刘梦园, 孙明军.急诊内镜下逆行胰胆管造影术治疗急性梗阻性胆管炎及胆源性胰腺炎疗效分析[J].临床军医杂志, 2017, 45 (5) :504-507.
    [9]SAKAI Y, TSUYUGUCHI T, SUGIYAMA H, et al.Current situation of endoscopic treatment for common bile duct stones[J].Hepatogastroenterology, 2012, 59 (118) :1712-1716.
    [10]ERSOZ G, TEKESIN O, OZUTEMIZ AO, et al.Biliary sphincterotomy plus dilation with a large balloon for bile duct stones that are difficult to extract[J].Gastrointest Endosc, 2003, 57 (2) :156-159.
    [11]TEOH AY, CHEUNG FK, HU B, et al.Randomized trial of endoscopic sphincterotomy with balloon dilation versus endoscopic sphincterotomy alone for removal of bile duct stones[J].Gastroenterology, 2013, 144 (2) :341-345.
    [12]ITOI T, SOFUNI A, ITOKAWA F, et al.New large-diameter balloon-equipped sphincterotome for removal of large bile duct stones (with videos) [J].Gastrointest Endosc, 2010, 72 (4) :825-830.
    [13]BARON TH, HAREWOOD GC.Endoscopic balloon dilation of the biliary sphincter compared to endoscopic biliary sphincterotomy for removal of common bile duct stones during ERCP:a meta analysis of randomized, controlled trials[J].Am J Gastroenterol, 2004, 99 (8) :1455-1460.
    [14]TSUJINO T, YOSHIDA H, ISAYAMA H, et al.Endoscopic papillary balloon dilation for bile duct stone removal in patients 60 years old or younger[J].J Gastroenterol, 2010, 45 (10) :1072-1079.
    [15]KIM KO, KIM TN, LEE SH.Endoscopic papillary large balloondilation for the treatment of recurrent bile duct stones in patients with prior sphincterotomy[J].J Gastroenterol, 2010, 45 (12) :1283-1288.
    [16]MEN CJ, ZHANG GL.The application of endoscopic sphincterotomy combined with endoscopic papillary large balloon dilation in the treatment of choledocholithiasis[J].Tianjin Med J, 2017, 45 (6) :620-623. (in Chinese) 门昌君, 张国梁.EST联合EPLBD不同扩张时间在胆总管结石中的应用[J].天津医药, 2017, 45 (6) :620-623.
    [17]VOUDOUKIS E, VARDAS E, THEODOROPOULOU A, et al.Conservative treatment of perforation following balloon dilation of the papilla after sphincterotomy[J].Endoscopy, 2012, 44 (Suppl2 UCTN) :e292-e293.
    [18]PARK SJ, KIM JH, HWANG JC, et al.Factors predictive of adverse events following endoscopic papillary large balloon dilation:results from a multicenter series[J].Dig Dis Sci, 2013, 58 (4) :1100-1109.
    • Relative Articles

  • Relative Articles

    [1]Huaqiang ZHANG, Lixin LIU, Xiaohong GUO. Association of nonalcoholic fatty liver disease with the risk of colorectal adenoma and colorectal cancer: A Meta-analysis[J]. Journal of Clinical Hepatology, 2021, 37(7): 1619-1625. doi: 10.3969/j.issn.1001-5256.2021.07.028
    [2]Qiaohong LIU, Yu ZHAO, Yiyang HU. Effect of diet on enterotype-related gut microbiota in nonalcoholic fatty liver disease[J]. Journal of Clinical Hepatology, 2021, 37(4): 939-942. doi: 10.3969/j.issn.1001-5256.2021.04.046
    [3]Juan PENG, Liangping LI. Mechanism of action of estrogen and its receptor in the development and progression of nonalcoholic fatty liver disease[J]. Journal of Clinical Hepatology, 2021, 37(2): 467-470. doi: 10.3969/j.issn.1001-5256.2021.02.046
    [4]Jinhong TANG, Long WANG. Research advances in the association between nonalcoholic fatty liver disease and colorectal adenomatous polyps[J]. Journal of Clinical Hepatology, 2021, 37(11): 2672-2675. doi: 10.3969/j.issn.1001-5256.2021.11.040
    [5]Yalan LEI, Jian BI, Jingwei MAO. Impact of nonalcoholic fatty liver disease on intestinal immune cells[J]. Journal of Clinical Hepatology, 2021, 37(11): 2667-2671. doi: 10.3969/j.issn.1001-5256.2021.11.039
    [6]Shenglan ZENG, Rongzhen ZHANG, Na WANG, Tingshuai WANG, Liting TAN, Dewen MAO. Effect of diet-gut microbiota axis on nonalcoholic fatty liver disease[J]. Journal of Clinical Hepatology, 2021, 37(11): 2676-2679. doi: 10.3969/j.issn.1001-5256.2021.11.041
    [7]Chenlu ZHAO, Wenxia ZHAO. Influence of estrogen deficiency on metabolic associated fatty liver disease in postmenopausal women[J]. Journal of Clinical Hepatology, 2021, 37(7): 1708-1712. doi: 10.3969/j.issn.1001-5256.2021.07.049
    [8]Tian TIAN, Wenwei HU, Xue LI, Jie WU, Dan ZHANG, Changzheng LI. Association between thyroxine level and nonalcoholic fatty liver disease[J]. Journal of Clinical Hepatology, 2021, 37(10): 2357-2363. doi: 10.3969/j.issn.1001-5256.2021.10.020
    [9]Xiangqian HUANG, Xiaomeng YAN, Mingda ZHANG, Jing WU, Jianhong CHEN. Association between nonalcoholic fatty liver disease and colorectal neoplasms[J]. Journal of Clinical Hepatology, 2021, 37(12): 2947-2950. doi: 10.3969/j.issn.1001-5256.2021.12.045
    [10]SUN MengYuan, XIANG XiaoXing. Role of gut microbiota and bile acid pathway in nonalcoholic fatty liver disease[J]. Journal of Clinical Hepatology, 2020, 36(12): 2831-2834. doi: 10.3969/j.issn.1001-5256.2020.12.040
    [11]Li HongShan, Hu YiYang. Gut microecology: An important target of traditional Chinese medicine in the treatment of nonalcoholic fatty liver disease[J]. Journal of Clinical Hepatology, 2020, 36(1): 14-18. doi: 10.3969/j.issn.1001-5256.2020.01.002
    [12]Hui DengCheng, Sun MingYu. Association between nonalcoholic fatty liver disease and gut microbiota based on the theory of gut-liver axis[J]. Journal of Clinical Hepatology, 2020, 36(7): 1627-1630. doi: 10.3969/j.issn.1001-5256.2020.07.039
    [13]Zhang Dan, Zhou Bo, Deng Yi, Wen Yu, Lu: JunYan, Wang JinXiang, Geng ZuoTao, Luo SuFeng, Ying YunYan, Wen DaiYan, Shi ChunJing, Pu GuangYu, Jiang Xin, Ma LanQing. Effect of fenofibrate on the diversity of intestinal flora in a mouse model of nonalcoholic fatty liver disease[J]. Journal of Clinical Hepatology, 2020, 36(4): 829-834. doi: 10.3969/j.issn.1001-5256.2020.04.024
    [14]Chuan LiXue, Chang Jiang, Zhao JinHan, Li LuoHua, Yang XuYao, Yu Di. Association between nonalcoholic fatty liver disease and colorectal adenomatous polyps[J]. Journal of Clinical Hepatology, 2020, 36(6): 1299-1303. doi: 10.3969/j.issn.1001-5256.2020.06.022
    [15]Feng Gong, He Na, Mi Man, Li XuePing, Liu ManLing, Fan LiPing, Niu ChunYan. Risk factors for the coexistence of inflammatory bowel disease and nonalcoholic fatty liver disease: A Meta-analysis[J]. Journal of Clinical Hepatology, 2019, 35(4): 835-839. doi: 10.3969/j.issn.1001-5256.2019.04.025
    [16]Liu SiFu, Xie ZhengYuan. Association between nonalcoholic fatty liver disease and colorectal tumors[J]. Journal of Clinical Hepatology, 2019, 35(9): 2091-2094. doi: 10.3969/j.issn.1001-5256.2019.09.046
    [17]Zhang XiaXia, Xu HongTuan, Xu YouQing. The natural history and clinical features of nonalcoholic fatty liver disease-related cirrhosis[J]. Journal of Clinical Hepatology, 2018, 34(1): 24-26. doi: 10.3969/j.issn.1001-5256.2018.01.004
    [18]Liu JiaQi, Zhou ShaoMing. Research advances in intestinal flora in nonalcoholic fatty liver disease[J]. Journal of Clinical Hepatology, 2017, 33(12): 2453-2456. doi: 10.3969/j.issn.1001-5256.2017.12.045
    [19]Lu Xu, Han Tao, Tian Yao, Lu BoWei, Zhang Qian. Research progress in roles of gut microbiota and bile acid metabolism in development and progression of NAFLD[J]. Journal of Clinical Hepatology, 2014, 30(11): 1225-1228. doi: 10.3969/j.issn.1001-5256.2014.11.034
    [20]Zhu Peng, Xu Zong, Wang YuMing. World Gastroenterology Organisation global guidelines：nonalcoholic fatty liver disease and nonalcoholic steatohepatitis[J]. Journal of Clinical Hepatology, 2014, 30(9): 842-845. doi: 10.3969/j.issn.1001-5256.2014.09.002
    • Supplements(0)
    • Cited By
  • Created with Highcharts 5.0.7Amount of accessChart context menuAbstract Views, HTML Views, PDF Downloads StatisticsAbstract ViewsHTML ViewsPDF Downloads2024-052024-062024-072024-082024-092024-102024-112024-122025-012025-022025-032025-040102030
    Created with Highcharts 5.0.7Chart context menuAccess Class DistributionFULLTEXT: 15.4 %FULLTEXT: 15.4 %META: 78.3 %META: 78.3 %PDF: 6.3 %PDF: 6.3 %FULLTEXTMETAPDF
    Created with Highcharts 5.0.7Chart context menuAccess Area Distribution其他: 8.3 %其他: 8.3 %其他: 1.0 %其他: 1.0 %Australia: 0.2 %Australia: 0.2 %China: 1.0 %China: 1.0 %Egypt: 0.3 %Egypt: 0.3 %India: 0.8 %India: 0.8 %Iraq: 0.3 %Iraq: 0.3 %Russian Federation: 0.2 %Russian Federation: 0.2 %United Kingdom: 0.1 %United Kingdom: 0.1 %United States: 0.2 %United States: 0.2 %[]: 1.0 %[]: 1.0 %上海: 1.3 %上海: 1.3 %中卫: 1.0 %中卫: 1.0 %临汾: 0.1 %临汾: 0.1 %临沧: 0.1 %临沧: 0.1 %丽水: 0.1 %丽水: 0.1 %乌鲁木齐: 0.1 %乌鲁木齐: 0.1 %伊犁: 0.1 %伊犁: 0.1 %佛山: 0.1 %佛山: 0.1 %凉山彝族自治州: 0.1 %凉山彝族自治州: 0.1 %北京: 8.1 %北京: 8.1 %北阿坎德: 0.3 %北阿坎德: 0.3 %南京: 0.4 %南京: 0.4 %南充: 0.1 %南充: 0.1 %南宁: 0.4 %南宁: 0.4 %南昌: 0.2 %南昌: 0.2 %南阳: 0.1 %南阳: 0.1 %卡纳塔克: 0.2 %卡纳塔克: 0.2 %台州: 0.7 %台州: 0.7 %吉林: 1.6 %吉林: 1.6 %呼和浩特: 0.2 %呼和浩特: 0.2 %唐山: 0.8 %唐山: 0.8 %嘉兴: 0.1 %嘉兴: 0.1 %四平: 0.1 %四平: 0.1 %多伦多: 0.1 %多伦多: 0.1 %大连: 0.1 %大连: 0.1 %天津: 1.2 %天津: 1.2 %常德: 0.1 %常德: 0.1 %广州: 0.9 %广州: 0.9 %延边: 0.2 %延边: 0.2 %弗吉尼亚州: 0.1 %弗吉尼亚州: 0.1 %张家口: 1.5 %张家口: 1.5 %徐州: 0.1 %徐州: 0.1 %成都: 0.5 %成都: 0.5 %新乡: 0.1 %新乡: 0.1 %新余: 0.1 %新余: 0.1 %昆明: 1.3 %昆明: 1.3 %晋城: 0.1 %晋城: 0.1 %曼谷: 0.1 %曼谷: 0.1 %朝阳: 0.1 %朝阳: 0.1 %杭州: 0.3 %杭州: 0.3 %松原: 0.1 %松原: 0.1 %武汉: 1.1 %武汉: 1.1 %河池: 0.1 %河池: 0.1 %泰州: 0.1 %泰州: 0.1 %济南: 0.3 %济南: 0.3 %海得拉巴: 0.4 %海得拉巴: 0.4 %淄博: 0.2 %淄博: 0.2 %淮北: 0.1 %淮北: 0.1 %淮安: 0.1 %淮安: 0.1 %深圳: 0.5 %深圳: 0.5 %湖州: 0.1 %湖州: 0.1 %湘潭: 0.1 %湘潭: 0.1 %潍坊: 0.1 %潍坊: 0.1 %珠海: 0.1 %珠海: 0.1 %眉山: 0.1 %眉山: 0.1 %石家庄: 0.2 %石家庄: 0.2 %秦皇岛: 0.1 %秦皇岛: 0.1 %聊城: 0.1 %聊城: 0.1 %芒廷维尤: 37.1 %芒廷维尤: 37.1 %芝加哥: 0.2 %芝加哥: 0.2 %苏州: 0.2 %苏州: 0.2 %莫斯科: 2.4 %莫斯科: 2.4 %莱芜: 0.1 %莱芜: 0.1 %衢州: 0.1 %衢州: 0.1 %襄阳: 0.1 %襄阳: 0.1 %西宁: 15.0 %西宁: 15.0 %贵阳: 0.4 %贵阳: 0.4 %辽阳: 0.1 %辽阳: 0.1 %运城: 1.8 %运城: 1.8 %连云港: 0.1 %连云港: 0.1 %邯郸: 0.1 %邯郸: 0.1 %重庆: 0.3 %重庆: 0.3 %银川: 0.2 %银川: 0.2 %锦州: 0.1 %锦州: 0.1 %长春: 1.4 %长春: 1.4 %长沙: 0.1 %长沙: 0.1 %鞍山: 0.1 %鞍山: 0.1 %香港: 0.1 %香港: 0.1 %鹤壁: 0.1 %鹤壁: 0.1 %黄冈: 0.1 %黄冈: 0.1 %黔南: 0.1 %黔南: 0.1 %其他其他AustraliaChinaEgyptIndiaIraqRussian FederationUnited KingdomUnited States[]上海中卫临汾临沧丽水乌鲁木齐伊犁佛山凉山彝族自治州北京北阿坎德南京南充南宁南昌南阳卡纳塔克台州吉林呼和浩特唐山嘉兴四平多伦多大连天津常德广州延边弗吉尼亚州张家口徐州成都新乡新余昆明晋城曼谷朝阳杭州松原武汉河池泰州济南海得拉巴淄博淮北淮安深圳湖州湘潭潍坊珠海眉山石家庄秦皇岛聊城芒廷维尤芝加哥苏州莫斯科莱芜衢州襄阳西宁贵阳辽阳运城连云港邯郸重庆银川锦州长春长沙鞍山香港鹤壁黄冈黔南

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索
    Get Citation
    PDF
    XML

    Article Metrics

    Article views (2545) PDF downloads(532) Cited by()
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[2389]YesterdayPV[5285]TodayIP[1960]TodayPV[4323]Online[50]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return