摘要目的 通过磁共振胰胆管造影(magnetic resonance cholangiopancreatography,MRCP)相关征象对内镜治疗胆总管结石术后结石复发患者进行相关因素分析.方法 回顾性分析2012年1月至2015年1月期间在进行内镜下十二指肠乳头括约肌小切开(endoscopic sphicterotomy,EST)+球囊扩张术(endoscopic pappillary balloon dilation,EPBD)手术治疗并有术前MRCP影像资料及随访资料的共734例患者,分别统计有结石复发与无结石复发患者的MRCP相关征象.结果 术前或术中胆囊切除、十二指肠乳头旁憩室、胆总管多发结石及胆总管走行角度是本组病例结石复发的独立危险因素.结论 EST小切开+EPBD术虽然尽量保留了Oddis括约肌的功能,但仍有一些因素会影响结石复发.

abstractsObjective To analyze the related risk factors of choledocholithiasis recurrence after endoscopic sphecterotomy (EST) and choledocholithotomy.Methods A retrospective analysis was made on 734 patients who underwent EST + endoscopic papillary balloon dilation and stones restraction (EPBD) operation with preoperative MRCP imaging and follow-up data from Jan 2012 to Jan 2015.The distribution of MRCP-related signs in patients with and without recurrence of stones was statistically analyzed.Results Preoperative or intraoperative cholecystectomy,peripapillary diverticulum,multiple choledocholithiasis and common bile duct angle were independent risk factors for recurrence of cholelithiasis.Conclusion Small incision EST + EPBD may preserve the function of Oddi sphincter and minimize the trauma to the patient,but there are still some preoperative factors that may affect the recurrence of stones.