ERCP在评估伴有阻塞性黄疸的胆总管扩张症病因中的作用  

UTILITY OF ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY IN THE EVALUATION OF CHOLEDOCHAL DILATATION WITH OBSTRUCTIVE JAUNDICE

作　　者：陈卫星[1] 厉有名[1] 许国强[1] 方英[1] 蔡曙萍[1] 

机构地区：[1]浙江医科大学附属第一医院消化内科

出　　处：《中国内镜杂志》1999年第3期7-8,共2页China Journal of Endoscopy

摘　　要：１６４例阻塞性黄疸患者进行了ＥＲＣＰ检查，对胆总管扩张组（ｎ＝１１０）的病因进行评估分析，并以胆总管不扩张组为对照组（ｎ＝５４）。结果：胆总管扩张的病因依次为胆总管结石、十二指肠乳头旁憩室、先天性胆总管囊肿等。胆总管扩张组的胆总管下端及其周围病变的发生率为９４．５５％，高于对照组２４．０８％；胆总管扩张组的十二指肠乳头旁憩室的发生率为２４．５５％，高于对照组９．２６％；胆总管扩张组胆囊术后病人的比率为１３．６４％，高于对照组５．５６％。认为胆总管扩张多由胆总管下端及其周围病变所致。One hudred and sixty-four patients with obstructive jaundice were investigated by endoscopic retrograde cholangiopancreatography(ERCP),and the causes of the group of choledochal dilatation (group Ⅰ,n=110)were evaluated compared with the control group without choledocal dilatation (group Ⅱ,n=54).The causes of common bile duct dilatation were choledocholith,juxtapapillary duodenal diverticula and congenital dilatation of common bile duct in turn.The distal common bile duct and around it were abnormal in 104 of the 110 patients in group Ⅰ(94.55%),and in only 13 of 54 patients in group Ⅱ(24.08%)( P <0.01).Juxtapapillary duodenal diverticulas presented 24.55% in group Ⅰ,and only 9.26% in group Ⅱ( P <0.05).Post-cholecystectomy patients were 13.64% in group I,and only 5.56% in group Ⅱ.In conclusion,we found that the abnormal of distal common bile duct and around it could usually be detected as the underlying cause of a significant common bile duct dilatation,it was necessary to perform ERCP before cholecystectomy,ERCP is considered the 'gold standard' of diagnosis for distal common bile duct abnormal.

关 键 词：逆行性 胆胰管造影 胆总管扩张 阻塞性黄疸 病因 

分 类 号：R575.702[医药卫生—消化系统] R575.06[医药卫生—内科学]