ERCP在胆胰结合部疾病中的应用  

Roles of ERCP in the treatment of disorders at pancreaticobiliary junction

作　　者：秦鸣放[1] 

机构地区：[1]天津市南开医院微创外科,天津300100

出　　处：《中国实用外科杂志》2010年第5期337-339,共3页Chinese Journal of Practical Surgery

摘　　要：随着十二指肠镜设备和器械发展,内镜逆行胰胆管造影(ERCP)在胆胰管结合部疾病治疗中占有非常重要地位。ERCP治疗的胆胰管结合部疾病主要包括结石、肿瘤、Oddi括约肌狭窄和胆胰管合流异常。胆胰管结合部结石嵌顿通过括约肌切开术(EST)或电针开窗可迅速缓解;无法根治性切除的恶性肿瘤可行内镜胆管引流术(ERBD)或内镜胆管金属支架术(EMBE)建立胆汁内引流,严重黄疸术前利用鼻胆导管引流术(ENBD)可有效减黄;Oddi括约肌狭窄行EST优势明显,已经代替传统开腹括约肌成型术;治疗无胆总管扩张的胰胆管合流异常现处于探索阶段。With the development and ewolution of duodenum endoscopy devices and instruments, endoscopic retrograde cholangiopanereatography （ERCP） has been playing more and more important roles in the treatment of disorders at pancreaticobiliary junction, which includes： henign bile stones, Oddi＇ s sphincter slenosis, anomahous panereatieobiliary junction and malignant lesions. he topics arc discussed in detail wilh hand-on experience of the author in the article. The impacted lille stones at the panereatiicobiliary , junction can be evaeuated by endoscopit, sphineterolomy （EST）. Surgically incural）le malignant lesions can be intraluminally drained by endoscopic retrograde biliary drainage （ERBD） or expandable melallic biliary endoprolhesis （EMBE）. Severe jaundice can be relieved by endoscopic nasobiliary drainage （ENBI））. Oddi＇ s sphincter sten.sis is effectively managed hy EST. In addition.the. treatment of anonlalous puncreaticobbiliary junetion without dilated conmon bile duct is still under investigation.

关 键 词：内镜逆行胰胆管造影 胆胰结合部 

分 类 号：R6[医药卫生—外科学]