经内镜逆行胰胆管造影联合反向导丝引导治疗胆管疾病  

Application of butt joint of reversing guidewire and endoscopic retrograde cholangiopancreatography in treatment of biliary disease

作　　者：邹传鑫[1] 王朝霞[2] 文卫[2] 王翔[2] 缪林[2] 王敏[2] 蒋国斌[2] 范志宁[2] 

机构地区：[1]湖北省荆州市中心医院消化内科,湖北荆州434020 [2]南京医科大学第二附属医院消化医学中心,江苏南京210011

出　　处：《中国内镜杂志》2010年第7期719-721,共3页China Journal of Endoscopy

摘　　要：目的介绍反向导丝与ERCP对接治疗胆道疾病的方法,并评价该方法对胆道疾病治疗的疗效。方法 45例经ERCP失败或不能耐受长时间常规ERCP而采用会师技术治疗的胆道疾病患者,经T管窦道、胆囊造瘘口或者PTCD,将导丝经胆总管导入十二指肠,再经十二指肠镜的活检孔道导出,导管在体外与ERCP导管对接后行胆道疾病的治疗。结果 45例有44例获得成功,经T管窦道30例,胆囊造瘘口2例,PTCD13例。无严重并发症发生。结论 ERCP失败时,会师技术是治疗胆道疾病的较好方法,简便易学,值得临床推广应用。【Objective】To introduce a method of the treatment of biliary disease butt joint of T-duct sinus tract,gallbladder stoma or percutaneous transhepatic cholangial drainage （PTCD） and endoscopic retrograde cholangiopancreatography （ERCP）,and study the clinical value of the method. 【Methods】45 patients with biliary disease were treated by butt joint of T-duct sinus tract,gallbladder stoma,PTCD and ERCP after ERCP failure or the patients who could not bear longer time ERCP. Over T-duct sinus tract,gallbladder stoma or PTCD,the guidewire was put into duodenum across the common bile duct （CBD）,then the guidewire was pulled out of the body through duodenoscopy biopsy channel,ERCP was done. 【Results】44 cases were succeed,one case was failure. 30 cases were succeeded by T-duct sinus tract,2 cases by gallbladder stoma,13 cases by PTCD. No serious complication occurred.【Conclusions】Butt joint of reversing guidewire and ERCP to the treatment of biliary disease is better method while ERCP failed. The method is easy to learn and has extensive generalizing value in clinic.

关 键 词：反向导丝 ERCP 对接 胆道疾病 

分 类 号：R657.4[医药卫生—外科学]