ERCP临床应用指征探讨  

Indication Selections of ERCP in Current Medical Condition

作　　者：所广军[1] 徐安[1] 胡海[1] 

机构地区：[1]同济大学附属东方医院微创外科,上海200120

出　　处：《中国普外基础与临床杂志》2011年第5期533-536,共4页Chinese Journal of Bases and Clinics In General Surgery

基　　金：浦东新区科技发展基金项目(项目编号:PKJ2009-Y21)~~

摘　　要：目的探讨临床应用内镜逆行胰胆管造影术(ERCP)的诊治指征。方法回顾性分析2005年1月至2009年12月期间我院采用ERCP方法进行诊断及治疗的患者的临床资料。结果 221例行ERCP的患者中,术中发现胆总管结石99例,占45%;恶性肿瘤44例,占20%;乳头狭窄9例,占4%;阴性45例,占20%;操作失败24例,占11%。年度分类统计显示,行ERCP的患者数逐年减少。ERCP术后并发症发生率为11%(25例),包括术后胰腺炎15例、出血3例、胆道感染5例及网篮头滞留2例。结论在影像学及腹腔镜技术高度发展的时代,应本着无创、微创的原则选择诊治方法,临床上不能无限扩大ERCP的应用指征。Objective To explore how to select the suitable indications of ERCP for clinical diagnosis and treatment.Methods The data of patients treated by ERCP between January 2005 and December 2009 in our hospital were analyzed retrospectively.Results Total 221 patients received ERCP,among whom 99（45%） cases of common bile duct stones,44（20%） cases of malignant tumor,9（4%） cases of papilla narrow,45（20%） cases were negative,and 24（11%） cases were failed.It had the trend that the number of the patients received ERCP reduced year by year.The postoperative complication rate was 11%（25 cases）,including 15 cases of postoperative pancreatitis,3 cases of bleeding,5 cases of biliary duct infection,and 2 cases of basket stranded.Conclusion In the modern medical condition,with the advancement of image and laparoscopy technology,we should select the diagnosis and treatment methods with the principles of no damage or less damage for patients,without unlimitedly broadening the clinical indications of ERCP.

关 键 词：内镜逆行胰胆管造影术 腹腔镜 胆总管结石 腹腔镜胆总管探查术 

分 类 号：R657.4[医药卫生—外科学] R616[医药卫生—临床医学]