Article(id=1208055575108231371, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1208055572495179979, articleNumber=null, orderNo=null, doi=10.11855/j.issn.0577-7402.2022.06.0607, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=research-article, receivedDate=1634140800000, receivedDateStr=2021-10-14, revisedDate=null, revisedDateStr=null, acceptedDate=1643126400000, acceptedDateStr=2022-01-26, onlineDate=1765952493693, onlineDateStr=2025-12-17, pubDate=1656345600000, pubDateStr=2022-06-28, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1765952493693, onlineIssueDateStr=2025-12-17, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1765952493693, creator=13701087609, updateTime=1765952493693, updator=13701087609, issue=Issue{id=1208055572495179979, tenantId=1146029695717560320, journalId=1189873630562394117, year='2022', volume='47', issue='6', pageStart='533', pageEnd='638', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1765952493070, creator=13701087609, updateTime=1765952764848, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1208056712481841868, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1208055572495179979, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1208056712481841869, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1208055572495179979, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=607, endPage=613, ext={EN=ArticleExt(id=1208055575380861133, articleId=1208055575108231371, tenantId=1146029695717560320, journalId=1189873630562394117, language=EN, title=Research progress in effect of endoscopic retrograde cholangiopancreatography on Oddi sphincter function, columnId=1190243275882729994, journalTitle=Medical Journal of Chinese People’s Liberation Army, columnName=Review, runingTitle=null, highlight=null, articleAbstract=
Oddi sphincter is an important valve controlling the biliopancreatic duct passage, and its injury can cause enterobiliary reflux, resulting in a series of long-term complications such as reflux cholangitis, cholecystitis, recurrence of calculi, and even cholangiocarcinoma. As one of the most common diseases of digestive system, choledocholithiasis is increasing year by year in recent years. Endoscopic retrograde cholangiopancreatography (ERCP) is the preferred minimally invasive method for the treatment of choledocholithiasis and has been widely used in clinical practice. But different ERCP procedures may damage Oddi sphincter. This article reviews the effects of ERCPs (endoscopic sphincterotomy, endoscopic papillary balloon dilation, endoscopic sphincterotomy plus balloon dilation, endoscopic endoclip papilloplasty) on Oddi sphincter and their respective advantages and disadvantages and application prospect.
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Oddi括约肌是控制胆胰管通道的重要阀门,其损伤会造成肠胆反流,引起反流性胆管炎、胆囊炎、结石再发,以及胆管癌等一系列远期并发症。胆总管结石作为临床最常见的消化系统疾病之一,近年来发病率逐渐增高。内镜逆行胰胆管造影术(ERCP)是治疗胆总管结石的首选微创方法,已广泛应用于临床,但其可能对Oddi括约肌造成损伤。本文对ERCP的几种主要术式(内镜下乳头括约肌切开术、内镜下十二指肠乳头气囊扩张术、内镜下乳头括约肌小切开联合气囊扩张术、内镜下钛夹乳头成形术)对Oddi括约肌功能的影响进行综述。
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焦黎,硕士研究生,主治医师,主要从事消化内镜临床应用方面的研究
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内镜下乳头括约肌切开术操作过程A. 十二指肠乳头(箭头方向为纵行切开方向);B. 内镜下乳头括约肌切开术中;C. 内镜下乳头括约肌切开术后
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Operation process of endoscopic papillary balloon dilation[22], figureFileSmall=hwriplyemhkQHjXeKzBi1g==, figureFileBig=BFQuJ10sYbO1jyHHBfxu5w==, tableContent=null), ArticleFig(id=1208055579138957563, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208055575108231371, language=CN, label=图2, caption=
内镜下十二指肠乳头气囊扩张术操作过程[22]A. 胆总管插管;B. 气囊扩张十二指肠乳头;C. 气囊扩张后;D. 经扩张的十二指肠乳头取石
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Effect on Oddi sphincter of several main operative methods of ERCP
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| 术式 | 胆管测压(较术前降低幅度) | 结石复发(发生率) | 反流性胆管炎(发生率) | 胆囊炎(发生率) |
|---|
| EST | 明显降低(72%~100%) | 高(10%~17%) | 高(2.9%~10.3%) | 高(3.1%~22%) |
| EPBD | 降低或无变化(0~32.8%) | 低(2.2%~6.8%) | 低(0~4.4%) | 低(2.2%~4.2%) |
| ESBD | 无变化 | 低(1.6%~2.2%) | 无 | 无 |
| EEPP | 无变化 | 低(0~3.3%) | 无 | 无 |
), ArticleFig(id=1208055579294146819, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1208055575108231371, language=CN, label=表1, caption=
ERCP几种主要术式对Oddi括约肌的作用
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| 术式 | 胆管测压(较术前降低幅度) | 结石复发(发生率) | 反流性胆管炎(发生率) | 胆囊炎(发生率) |
|---|
| EST | 明显降低(72%~100%) | 高(10%~17%) | 高(2.9%~10.3%) | 高(3.1%~22%) |
| EPBD | 降低或无变化(0~32.8%) | 低(2.2%~6.8%) | 低(0~4.4%) | 低(2.2%~4.2%) |
| ESBD | 无变化 | 低(1.6%~2.2%) | 无 | 无 |
| EEPP | 无变化 | 低(0~3.3%) | 无 | 无 |
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