ERCP对不明原因胆总管扩张的诊断价值  

The Value of Endoscopic Retrograde Cholangiopancreatography (ERCP) in Diagnosing the Non-identifiedly Etiological Factors Choledochus Expansion

作　　者：盛红 叶国良 陈会松 柯进晶[2] 

机构地区：[1]浙江省象山县第一人民医院消化内科,315700 [2]浙江省人民医院消化内科

出　　处：《医学研究杂志》2007年第6期118-119,共2页Journal of Medical Research

摘　　要：目的探讨ERCP对不明原因的胆总管扩张的诊断价值。方法对50例临床体外超声检查发现有胆总管扩张、但病因诊断有困难的患者,其中临床上伴有黄疸33例,不伴有黄疸17例,进一步行CT、ERCP检查,对胆总管扩张的病因进行评估分析。结果伴黄疸的胆管扩张的病因主要为胆总管结石、胆总管下段癌、壶腹部癌、胰腺癌、肝内胆管乳头状瘤、胆总管隔膜症、Mirrizi综合征等。不伴有黄疸的胆管扩张的病因主要为十二指肠乳头旁憩室、胆总管下段炎、慢性胰腺炎、胆总管下段腺瘤等。结论ERCP可清晰地观察乳头周围及整个胆管树形态,对不明原因的胆总管扩张有很高的诊断价值。Objective Exploring The value of ERCP（ endoscopic retrograde cholangiopancreatography） in diagnosing the Non - identified choledochus expansion. Methods 50 patients were given the ones about the computerized tomography （CT） and the ERCP （ endoscopic retrograde cholangiopancreatography） besides B -type ultrasound the detections, which had manifested the choledochus expansion of patients ,but it is difficult for us to search the etiological factors ,and there are 33 patients accompaniment with jaundice symptoms but 17 no jaundice symptoms. At the same time ,the etiological factors of choledochus expansion were evaluated. Results The etiological factor of choledochus expansion along with jaundice mainly come from the choledocholith and the inferior segment choledochus cancer and the duodenal ampulla cancer and the pancreatic carcinoma and the intrahepatic bile duct papilloma and the choledochus diaphragma symptom and the Mirrizi syndrome and so on, but the ones without jaundice are mainly from the diverticulum on the side of duodenal papilla and the inferior segment choledochus inflammation and the chronical pancreatitis and the inferior segment choledochus adenoma and so on. Conclusions We can observe clearly the dendriform formation of biliary ducts and the surroundings of duodenal papilla , and so we think that ERCP has the very highly value in diagnosing the Non - identifiedly etiological factors choledochus expansion.

关 键 词：逆行胰胆管造影 不明原因的胆总管扩张 病因诊断 

分 类 号：R735.8[医药卫生—肿瘤]