Experience in treating 387 cases of bile duct diseases under duodenoscope / 中国微创外科杂志

ABSTRACT

Objective To explore how to improve the curative effects and reduce the complications of duodenoscopy in the treatment of bile duct diseases. Methods Clinical data of 292 cases of endoscopic sphincterotomy (EST) and 104 cases of endoscopic nose biliary drainage (ENBD, including 9 post-EST cases) from February 1995 to February 2003 were retrospectively reviewed. Results The success rate of EST was 92.1% (269/292). Among 272 cases of common bile duct calculus, stones were completely taken out in 235 cases (86.4%). Among 15 cases of intrahepatic duct calculus, stones were completely removed in 4 cases. Biliary duct foreign bodies were removed at once in 3 out of 5 cases. EST related complications were found in 16 cases (7 cases of acute pancreatitis, 5 cases of bleeding at the site of incision, 2 cases of severe cholangitis, 1 case of duodenal perforation and 1 case of instrumental break-off), with an incidence rate of 5.5% (16/292). Satisfactory outcomes were achieved in 92 cases receiving ENBD. No death occurred in the study. Conclusions Proper selection of patients and skillful performance of EST is the key to improve its curative effects and reduce its complications.