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一种新型网篮在无射线内镜胆总管结石取石术中的应用研究(含视频)

Evaluation of a newly designed basket in non-radiation endoscopic lithotomy for common bile duct stones (with video)

摘要目的:评价一种适用于胆道子镜的新型取石网篮在无射线内镜胆总管结石取石术中的应用价值。方法:纳入2021年2—10月在东南大学附属中大医院接受无射线胆道镜下胆总管结石取石术的78例患者进行随机对照研究,按照抽签法随机分为新型网篮取石组(35例)及普通网篮取石组(43例),分析并比较2组之间胆道镜探查次数、网篮取石次数、术中注水量、取石及胆道镜探查时间、总体内镜操作时间以及术后不良事件。结果:与普通网篮取石组比较,新型网篮取石组胆道镜探查次数较少[(1.08±0.28)次比(2.30±0.51)次, t=-12.535, P<0.001],术中注水量较少[(46.14±11.89)mL比(78.62±10.09)mL, t=-13.052, P<0.001],取石及胆道镜探查时间较短[(9.69±2.97)min比(12.67±2.51)min, t=-4.815, P<0.001],总体内镜操作时间也较短[(30.17±7.19)min比(33.44±6.69)min, t=-2.076, P=0.041]。2组之间不良事件发生率差异无统计学意义[5.7%(2/35)比11.6%(5/43), χ2=0.826, P=0.363]。 结论:新型取石网篮胆总管取石操作时间短,胆道镜探查次数少,术中注水量少,能够方便胆道镜直视下的无射线取石。

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abstractsObjective:To evaluate a newly designed basket fit for digital cholangioscope in non-radiation endoscopic lithotomy for common bile duct stones.Methods:Seventy-eight patients who underwent non-radiation endoscopic removal of common bile duct stones at Zhongda Hospital Southeast University between February and October 2021 were enrolled in the randomized controlled trial, and were randomly assigned into the new basket group ( n=35) and the conventional basket group ( n=43) by drawing lots. Procedures of cholangioscope-based biliary exploration and stone removal by baskets, volume of water irrigation, time lengths of biliary exploration, stone removal and whole endoscopic procedure, and adverse events were compared. Results:Compared with the conventional basket group, the new basket group needed less biliary explorations (1.08±0.28 VS 2.30±0.51, t=-12.535, P<0.001), smaller volume of water irrigation (46.14±11.89 mL VS 78.62±10.09 mL, t=-13.052, P<0.001), and shorter time of biliary exploration and stone removal (9.69±2.97 min VS 12.67±2.51 min, t=-4.815, P<0.001) and whole endoscopic procedure (30.17±7.19 min VS 33.44±6.69 min, t=-2.076, P=0.041). The incidence of adverse events was not significantly different between the two groups [5.7% (2/35) VS 11.6% (5/43), χ2=0.826, P=0.363]. Conclusion:This newly designed basket can facilitate digital cholangioscope-guided non-radiation endoscopic removal of common bile duct stones with the advantages of shorter operation time, less exploration time of choledochoscopy and smaller volume of water irrigation.

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