内窥镜逆行胰胆管造影加乳头切开术在胆管梗阻性疾病中的诊疗价值  

The diagnostic and therapeutic value of ERCP and EST in obstructive disease of bile duct

作　　者：张爱农[1] 何向阳[1] 文琴[1] 

机构地区：[1]安徽省红十字铜陵医院放射科,安徽铜陵244000

出　　处：《中国中西医结合影像学杂志》2007年第1期24-26,共3页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的:评价内窥镜下逆行胰胆管造影(ERCP)对胆管梗阻性疾病的诊断以及内窥镜下乳头括约肌切开术(EST)治疗胆总管结石的价值。方法:回顾性分析82例经手术、病理证实的ERCP表现以及62例胆总管结石的EST取石治疗。结果:本组82例,78例ERCP显示异常,其中胆管结石65例,胆管癌7例,胆管炎症狭窄3例,胆总管囊肿、胆道蛔虫、外科手术后胆总管瘘各1例。4例ERCP未显示病变,ERCP对胆管梗阻性疾病诊断正确率为95.1%(78/82)。ERCP指导EST行网篮、球篮和机械碎石网篮取石,取石60例,2例失败,取石成功率为96.8%(58/60)。结论:ERCP对胆管梗阻性疾病有较高的诊断价值,同时在EST网篮碎石、取石中具有重要的基础作用,可指导网篮取石及观察疗效。Objective：To evaluate the diagnostic and therapeutic value of endoscopic retrograde cholangiopancreatography （ERCP） and endoscopic sphincterotomy （EST） in obstructive disease of bile duct. Methods：The ERCP manifestation of 82 cases proved by operation and pathology were analyzed retrospectively, and 62 cases were treated by EST among them. Results： The abnormal imaging features of ERCP were reviewed in 78 cases （78/82）, of which 65 cases were cholelithiasis, 7 carcinoma of bile duct, 3 cholangitic stenosis, 1 choledochocgst, 1 ascariasis of biliary tract, 1 biliary fistula, and 4 cases were normal. The diagnostic accuracy of ERCP was 95.1% （78/82）. sixty cases of choledocholithiasis were treated by using lithotomy basket, lithotomy balloon and mechanical lithotrcptic basket, of which 2 cases were failure, its successful rate was 96.8% （58/60）. Conclusion： ERCP is of important value in diagnosing obstructive disease of bile duct and EST is reliable in treating choledocholithiasis.

关 键 词：内窥镜下逆行胰胆管造影 胆管梗阻性疾病 影像诊断 胆总管结石 乳头括约肌切开术 

分 类 号：R657.4[医药卫生—外科学]