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| 1 | Is endoscopic papillary balloon dilatation really a risk factor for post-ERCP pancreatitis?显示文摘Endoscopic papillary balloon dilatation(EPBD) is useful for decreasing early complications of endoscopic retrograde cholangio-pancreatography(ERCP), including bleeding, biliary infection, and perforation, but it is generally avoided in Western countries because of a relatively high reported incidence of post-ERCP pancreatitis(PEP). However, as the efficacy of endoscopic papillary largeballoon dilatation(EPLBD) becomes widely recognized, EPBD is attracting attention. Here we investigate whether EPBD is truly a risk factor for PEP, and seek safer and more effective EPBD procedures by reviewing past studies. We reviewed thirteen randomised control trials comparing EPBD and endoscopic sphincterotomy(EST) and ten studies comparing direct EPLBD and EST. Three randomized controlled trials of EPBD showed significantly higher incidence of PEP than EST, but no study of EPLBD did. Careful analysis of these studies suggested that longer and higher-pressure inflation of balloons might decrease PEP incidence. The paradoxical result that EPBD with small-calibre balloons increases PEP incidence while EPLBD does not may be due to insufficient papillary dilatation in the former. Insufficient dilatation could cause the high incidence of PEP through the use of mechanical lithotripsy and stress on the papilla at the time of stone removal. Sufficient dilation of the papilla may be useful in preventing PEP. | Toshio Fujisawa Koichi Kagawa Kantaro Hisatomi Kensuke Kubota Atsushi Nakajima Nobuyuki Matsuhashi | 2016 | World Journal of Gastroenterology2016，22，26： | 23 |
| 2 | 经内镜乳头括约肌小切开联合柱状球囊扩张术治疗胆总管结石36例分析显示文摘目的了解经内镜乳头括约肌小切开术联合柱状球囊扩张术(EPBD)治疗胆总管结石的疗效及其安全性。方法 2011年2月至2014年2月收治的36例胆总管结石患者,均经内窥镜逆行胰胆管造影术(ERCP)确诊为胆总管结石(单发性结石25例,多发性结石11例);结石直径5~15 mm;既往实施过胆囊切除术28例,均无胆肠吻合术及胃大部切除术史。本次住院均采用内镜乳头括约肌小切开术联合EPBD治疗,观察治疗效果及术中、术后并发症。结果 36例患者中一次取石成功率97.22%。术后出血率2.78%,术后急性胰腺炎发生率5.56%,1年内结石复发率8.33%,无胆管炎及肠穿孔并发症发生。结论经内镜乳头括约肌小切开术联合EPBD治疗胆总管结石,术中、术后并发症少,疗效确切。 | 赵昌杰 陈林 | 2016 | 中国临床研究2016，29，1： | 10 |
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