Endoscopic treatment of difficult extrahepatic bile ductstones, EPBD or EST： An anatomic view

• 作者: Fu Li Hong-Yi Zhu Jun Ding Xi-Wen Zhang
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: ENDOSCOPIC retrograde CHOLANGIOPANCREATOGRAPHY Common bile duct stone ENDOSCOPIC SPHINCTEROTOMY ENDOSCOPIC papillary balloon DILATION
• 年，卷（期）: 2015,（3）
• 页码范围: 274-277
• 页数: 4页
• 分类号: R

摘要

Large bile duct stone （〉 10 mm） or multiple stones（≥ 3） are challenging for endoscopists. Endoscopicsphincterotomy （EST） is a routine therapeutic endoscopicretrograde cholangiopancreatography （ERCP） procedureusually used. It is safe and effective, but severeperforation or massive bleeding are the main causesof mortality. Because of the permanent destroy ofOddi sphincter, the use of EST is still controversial.Endoscopic papillary balloon dilation （EPBD） givesanother way to open the sphincter. Less incidence ofbleeding, perforation and partly preserving the Oddisphincter＇s function are the main advantages. Buthigh incidence of post-ERCP pancreatitis becomes apredominant problem. According to the anatomicalfeature of Oddi sphincter, limited EST ＋ EPBD seems amore reasonable procedure. Compared to the formertwo procedures, it makes the stone extraction processmuch easier with lower incidences of short-term andlong-term complications.