• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Surgical Endoscopy >Endoscopic sphincterotomy for stenosis of the sphincter of Oddi.
【24h】

Endoscopic sphincterotomy for stenosis of the sphincter of Oddi.

机译：内镜括约肌切开术治疗Oddi括约肌狭窄。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

BACKGROUND: Sphincter of Oddi dysfunction (SOD) is one of the causes of postcholecytectomy syndrome and biliary pain. Endoscopic sphincterotomy (EST) is recommended in some cases for patients refractory to conservative treatment. By the Milwaukee classification, patients with biliary pain can be divided into three groups. Group I patients show all the objective signs suggestive of a disturbed bile outflow-i.e., elevated liver function tests, dilated common bile duct (CBD), and delayed contrast drainage during endoscopic retrograde cholangio pancreatography (ERCP). Group II patients have biliary-type pain along with one or two of the criteria from group I. Group III patients have only biliary pain, with no other abnormalities. This study confirms the effectiveness of EST for the relief of symptoms in group I patients (papillary stenosis). METHODS: Between 1989 and 1999, we treated eight patients clinically diagnosed as having group I papillary stenosis by EST. Their ages ranged from 52 to 73 years. In addition to biliary pain, all patients were found to have dilated CBD, elevated enzyme levels, and delayed contrast drainage at ERCP. None of the patients had CBD stones or other causes of obstruction. Sphincter of Oddi manometry was not performed. RESULTS: EST was successfully performed in eight patients. Each patient had a very large papilla. A false orifice was found in one patient. In five patients, endoscopic cannulation of the bile duct was very difficult. The use of a long, tapered catheter and guidewire papillotomy was necessary in four patients. A precut papillotomy was performed in one patient. All patients achieved resolution of their symptoms after EST. There were no complications. The average length of the follow-up period was 26 months. CONCLUSIONS: SOD is a real entity that continues to pose a diagnostic dilemma. EST is an effective and safe modality for the treatment of papillary stenosis (group I patients). SOD manometry is not necessary before EST in group I patients.
机译：背景：Oddi括约肌功能障碍（SOD）是胆囊切除术后综合征和胆道疼痛的原因之一。对于某些保守治疗难以耐受的患者，建议内镜括约肌切开术（EST）。通过密尔沃基分类，胆道疼痛患者可分为三组。第一组患者显示出所有客观症状提示胆汁流出受阻，即内窥镜逆行胰胆管造影（ERCP）期间肝功能检查升高，胆总管扩张（CBD）和造影剂引流延迟。 II组患者有胆汁型疼痛，以及I组中的一种或两种标准。III组患者只有胆汁痛，没有其他异常。这项研究证实了EST缓解I组患者（乳头狭窄）症状的有效性。方法：在1989年至1999年之间，我们治疗了8例经EST诊断为I组乳头状狭窄的患者。他们的年龄从52岁到73岁不等。除胆道疼痛外，所有患者在ERCP时均发现CBD扩张，酶水平升高和造影剂引流延迟。没有患者有CBD结石或其他阻塞原因。未进行Oddi括约肌测压。结果：EST成功进行了八例患者。每个病人都有一个非常大的乳头。在一名患者中发现了错误的孔口。在五名患者中，内镜下胆管插管非常困难。四名患者必须使用细长的锥形导管和导丝乳头切开术。对一名患者进行了预切乳头切开术。所有患者在EST后症状均得到缓解。没有并发症。随访时间平均为26个月。结论：SOD是一个真正的实体，继续构成诊断难题。 EST是治疗乳头状狭窄（I组患者）的有效且安全的方式。 I组患者在EST前无需进行SOD测压。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号