거대 담관담석의 치료에서 내시경 유두큰풍선확장술 단독과 내시경 유두괄약근절개술을 함께 시행하는 내시경 유두큰풍선확장술의 비교
Endoscopic large-balloon dilation alone versus endoscopic sphincterotomy plus large-balloon dilation for the treatment of large bile duct stones
- 발행기관 아주대학교
- 지도교수 김진홍
- 발행년도 2013
- 학위수여년월 2013. 8
- 학위명 박사
- 학과 및 전공 일반대학원 의학과
- 실제URI http://www.dcollection.net/handler/ajou/000000014949
- 본문언어 영어
- 저작권 아주대학교 논문은 저작권에 의해 보호받습니다.
초록/요약
Endoscopic sphincterotomy (EST) combined with large-balloon dilation (LBD) has been proposed as an alternative to manage large bile duct stones. However, recent reports indicate that LBD without EST may be safe and effective in this setting. One hundred thirty-one patients with large common bile duct (CBD) stones 12 mm in size or larger underwent LBD alone (n = 62) or EST plus LBD (n = 69) for lithotripsy. The therapeutic outcome and complications were reviewed and compared. There were no differences between the two groups with regard to age, size and number of stones, or bile duct diameter. The LBD alone group (mean age, 70.4 years) and the EST plus LBD group (mean age, 68.2 years) had similar outcomes in terms of overall successful stone removal (96.8% vs. 95.7%, P = 0.738) and complete stone removal without the need for mechanical lithotripsy (80.6% vs. 73.9%, P = 0.360). Complications in the LBD alone and EST plus LBD groups were as follows: pancreatitis (6.5% vs. 4.3%, P = 0.593), impaction of basket and stone (0% vs. 1.4%, P = 0.341), and perforation (0% vs. 1.4%, P = 0.341). LBD alone may be a simple, safe, and effective alternative to EST plus LBD in relatively aged patients with large CBD stones, and it can simplify the procedure compared with EST plus LBD.
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ABSTRACT --------------------------- i
TABLE OF CONTENTS ---------------- ii
LIST OF FIGURES -------------------- iii
LIST OF TABLES --------------------- iV
I. INTRODUCTION --------------------1
II. MATERIALS AND METHODS --------2
III. RESULTS --------------------------6
IV. DISCUSSION ---------------------- 9
V. CONCLUSION --------------------- 12
REFERENCES -------------------------13
국문요약 ------------------------------17
