食管胃静脉曲张患者伴胰胆疾病内镜下治疗的研究  

ERCP for patients with gastroesophageal varices combined with pancreatobiliary diseases

作　　者：令狐恩强[1] 杨云生[1] 李志群[1] 李闻[1] 蔡逢春[1] 孙刚[1] 黄启阳[1] 杜红[1] 王向东[1] 孟江云[1] 孔金艳[1] 

机构地区：[1]中国人民解放军总医院消化内科,北京100853

出　　处：《中华腔镜外科杂志（电子版）》2011年第5期31-33,共3页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

摘　　要：目的本研究对193例行经内镜逆行胰胆管造影(ERCP)诊治的食管胃静脉曲张伴胰胆疾病患者进行回顾性分析,以期了解ERCP对食管胃静脉曲张伴胰胆疾病的诊断价值。方法对食管胃静脉曲张患者行常规内镜检查,同时行ERCP检查及治疗193例次。部分食管胃静脉曲张伴胰胆疾病者给予常规内镜下初级预防治疗,部分食管胃静脉曲张伴胰胆疾病者直接作ERCP检查。结果发现化脓性胆管炎10例;肝、胆管结石共47例;原发性肝癌8例;胆管癌3例;胆管癌栓6例;胰腺癌3例;十二指肠乳头病变4例;胆管狭窄29例;乳头括约肌切开15例;胆管支架31例;迟发性出血2例,出血并发症发生率1%;结论对所有食管胃静脉曲张伴胰胆疾病者作ERCP检查是安全、有效的,但其并发症等相关因素还需要长期大样本的研究。Objective To determine the safety and effects of performing ERCP on patients with gastroesophageal varices combined with pancreatobiliary diseases. Methods Data of 193 patients with gastroesophageal varices combined with pancreatobiliary diseases who underwent routine endoscopy and ERCP were analyzed. Patients either received primary preventive endoscopic treatment of gastroesophageal varices before ERCP or directly recieved ERCP. Results 10 patients were with suppurative cholangitis,47 with biliary stones,8 with hepatic carcinoma,3 with bile duct carcinoma,6 with bile duct cancer embolus,3 with pancreatic cancer,4 with lesions of duodenal papilla and 29 with bile duct stenosis.51 patients underwent endoscopic sphincterotomy,and 31 with biliary stent placement.Delayed bleeding occurred in 2（1%） patients. Conclusions For patients with gastroesophageal varices combined with pancreatobiliary diseases,ERCP is safe and effective,but its complications still need long-term and large-scale studies.

关 键 词：食管胃静脉曲张 胰胆疾病 经内镜逆行胰胆管造影 

分 类 号：R571.3[医药卫生—消化系统]