经内镜逆行胰胆管造影并发症的防治探讨  

Prophylaxis and Ttreatment for The Complication of Endoscopic Retrograde Cholangiopancreatography

作　　者：马吉安[1] 张贵清[1] 黎春华[1] 李文碧[1] 

机构地区：[1]四川省达州市第二人民医院,635000

出　　处：《中国消化内镜》2009年第4期27-29,共3页Digestive Disease and Endoscopy

摘　　要：目的探讨经内镜逆行胰胆管造影(ERCP)并发症的防治措施。方法对212例患者经内镜逆行胰胆管造影进行肝胆胰疾病的诊断和治疗,常规行ERCP检查,证实胆管内有结石后行EST,并根据结石部位、大小及胆总管直径大小采取不同的处理方法。结果212例患者经内镜逆行胰胆管造影成功203例(95.75%),其中142例经内镜乳头括约肌切开术进行胆胰疾病治疗,成功133例(93.66%);发生并发症32例(15.09%),急性胰腺炎13例、急性胆管炎12例、消化道出血5例、肠穿孔1例、结石和网蓝嵌顿1例。发生并发症的患者29例保守治疗、3例中转外科手术治疗后好转。结论诊治性ERCP中,急性胆管炎和急性胰腺炎是常见的并发症,大多并发症经保守治疗能够治愈,严格掌握适应症、遵守操作规程是减少并发症发生的重要因素。Objective： To explore the complications of ERCP （endoscopic retrograde cholangiopancreatography） and its related prevention and control measures. Methods： We studied 212 consecutive patients undergoing ERCP diagnosis and therapy. We performed EST after biliary stones were found, and took different measures according to the location, size and diameter of common bile duct. Results： ERCP and EST were successfully performed in 203（203/212, 95.75%） and 133（133/142, 93.66%） patients accordingly. A total of 32 complications were found, including 13 cases acute pancreatitis, 12 cases acute cholangeitis, 5 cases digestive tract bleeding, 1 case intestinal perforation and 1 case biliary stone incarceration. We perfomed conservative treatments in 29 patients and surgical treatment in 3 patients. Conclusions： acute cholangeitis and acute pancreatitis are most common complications in ERCP diagnosis. The majority of complications can be cured by conservative treatments. Selecting the indications carefully and complying with operation rules are important factors to decrease complications.

关 键 词：内镜逆行胰胆管造影术 并发症 预防 治疗 

分 类 号：R576[医药卫生—消化系统] R657.42[医药卫生—内科学]