内镜技术治疗良性胆管狭窄的应用价值  

Applicative value of duodenoscopic treatment in benign billiary strictures

作　　者：姚永刚[1] 谢明[1] 赵秋[2] 邹传鑫[1] 戴绍军[1] 马鹏[1] 王朝霞[1] 张媛[1] 

机构地区：[1]华中科技大学附属荆州市中心医院消化内科,湖北荆州434020 [2]华中科技大学附属同济医院消化内科,湖北武汉430056

出　　处：《中国内镜杂志》2012年第10期1083-1086,共4页China Journal of Endoscopy

摘　　要：目的探讨内镜技术在治疗良性胆管狭窄中的应用价值。方法对23例具有临床症状的良性胆管狭窄患者采用内镜下乳头括约肌切开术(EST)、狭窄部扩张术联合多支架内支撑术进行治疗。结果 23例患者均完成首次治疗,临床症状有效缓解。1例Mirizzi综合征患者经鼻-胆管引流后转外科手术治疗;2例(腹腔镜胆囊切除术后Oddi括约肌功能障碍、十二指肠乳头炎性狭窄者)仅行EST;20例接受狭窄部扩张+多支架内支撑术治疗,其中18例治愈,2例仍处于治疗观察期;总的治愈率87%,并发症发生率10.6%。结论经内镜治疗胆管良性狭窄具有微创、安全、有效、可反复治疗的优点,应该作为首选方法在临床上推广应用。[Objective] To evaluate the applicative value of duodenoscopic in the treatment of benign billiary strictures.[Methods] 23 patients with benign billiary stricture who have clinical symptom were treated with endoscopic sphincterotomy（EST）,dilating the bile duct stricture and the placement of multiple plastic stents from Jingzhou Hospital between March 2008 and January 2011.[Results] The clinical symptoms were improved after completing initial duodenoscopic treatment in 23 patients.Of these 23 patients,1 patient with Mirizzi Syndrome was transferred to the surgical department after endoscopic nasobiliary drainage（ENBD）;Only 2 patients of the sphincter of Oddi dysfunction and the inflammatory strictured of duodenal papillary after laparoscopic cholecystectomy were treated with endoscopic sphincterotomy（EST）;There were 20 patients received dilating the bile duct stricture and the placement of multiple plastic stents treatment,and among them 18 were cured and other 2 were to be in the remedial treatment period.The total cure rate was 87% and the incidence of complications was 10.6%.[Conclusions] Duodenoscopic treatment of benign billiary strictures has advantages of micro-invasive,effective,safe and repeated treatments.It is worth applying as the treatment of first choice for benign billiary strictures in clinical practice.

关 键 词：良性胆管狭窄 内镜治疗 狭窄部扩张 多支架内支撑术 

分 类 号：R575.7[医药卫生—消化系统]