ERCP联合PTC治疗ERCP难治性胆道梗阻15例  

ERCP Unites PTC to Treat Biliary Duct Obstruction With ERCP Treatment Failure

作　　者：王军华[1] 苏树英[1,2] 费凛[1] 许卓明[1] 

机构地区：[1]佛山市第一人民医院胆道外科,广东佛山528000 [2]广东省医学院

出　　处：《中南医学科学杂志》2011年第4期432-434,共3页Medical Science Journal of Central South China

摘　　要：目的探讨内镜逆行胰胆管造影术(ERCP)联合超声引导下经皮肝穿刺胆道放置导丝(PTC)治疗难治性胆道梗阻的可行性。方法对15例胆道梗阻ERCP(胆总管结石3例,胆总管癌8例,壶腹周围癌4例)治疗失败患者,先超声引导下PTC放置导丝入十二指肠,ERCP时经过此导丝行奥迪氏括约肌切开网篮取石或胆道支架植入术。观察其临床效果。结果 15例均获得成功,右侧肝管穿刺11例,左侧肝管4例,未发生明显并发症。3例胆总管结石患者均取石成功,12例恶性梗阻性黄疸患者3天后查血胆红素均明显下降。结论 ERCP联合PTC在胆道梗阻单纯ERCP不成功时是一种不错的治疗方法,但是对技术要求比较高,要严格把握其适应症。Objective To search for the feasibility of the treatment of difficult biliary duct obstruction through Endoscopic Retrograde Cholangiography Pancreas（ERCP） uniting under the supersonic guidance to place the wire by Percutaneous Transhepatic Cholangiography（PTC） .Methods For 15 cases of biliary duct obstruction with the defeat through ERCP（3 examples with choledoch stone,8 examples with choledoch cancer,4 examples with around ampule cancer） ,under the supersonic guidance the PTC laying aside leads the wire entering the duodenum,when ERCP passes through this wire,stones were taken through Audi sphincter incision network basket or the biliary duct support implantation.Its clinical effect was observed.Results 15 cases obtained success,which including 11 cases of right flank duetus hepaticus puncture and 4 cases of left side ductus hepaticus punture,moreover there were no obvious complications developed in all patients.There were no obvious complication.Three choledoch stone patients were succeeded in taking the stone,and the hemobilirubin of 12 malignancy obstruction jaundice patients obviously dropped.Conclusion ERCP unites PTC is a good method of treatment when biliary duct obstruction treated with pure ERCP is not successful,but it depends on the higher technique,and we must grasp its indication strictly.

关 键 词：胰胆管造影术(ERCP) 皮肝穿刺 胆道梗阻 

分 类 号：R657.43[医药卫生—外科学]