KẾT QUẢ ĐIỀU TRỊ SỎI ỐNG MẬT CHỦ KÍCH THƯỚC LỚN BẰNG NỘI SOI MẬT TỤY NGƯỢC DÒNG KẾT HỢP CẮT CƠ VÒNG ODDI VÀ NONG CƠ VÒNG ODDI BẰNG BÓNG TẠI TRUNG TÂM TIÊU HÓA – GAN MẬT, BỆNH VIỆN BẠCH MAI

Abstract

Objective: To evaluate the treatment results of large common bile duct stones using endoscopic retrograde cholangiopancreatography (NSMTND) combined with minimal sphincterotomy and large balloon dilation. Subjects and methods: A case series study on 82 patients with common bile duct stones >1 cm indicated for NSMTND treatment. All patients underwent administrative information collection, pre-intervention ultrasound evaluation of stones, NSMTND stone removal according to a standardized protocol, and complications of the procedure were recorded. Results: The successful cannulation rate was 93.9%, the complete stone clearance rate was 89,6%. The average procedure time was 31.4 minutes. Complications were usually mild, including 1 case of gastrointestinal perforation was treated endoscopically, 5 cases acute pancreatitis, 7 cases of bleeding. The complete stone clearance rate by NSMTND in the group with distal stone location, stone size <15mm, single stone, and non-angulated common bile duct was 98.0%, 87.3%, 92.3%, and 96.4% respectively, significantly higher (p<0.05) compared to the other groups. The accumulated stones clearance rate after the second and third times NSMTND is 85.7% and 89.6% respectively. Conclusion: Endoscopic retrograde cholangiopancreatography is an easily performed procedure with a high success rate of stone removal and few serious complications.