经内镜逆行胰胆管造影术在儿童青少年胆胰疾病诊治中的临床应用  

Analysis of the role of endoscopic retrograde cholangiopancreatography in children with pancreaticobiliary diseases

作　　者：刘伟[1] 王啓名[1] 曾泓泽[1] 牟一[1] 易航[1] 吴春成[1] 胡兵[1] 唐承薇[1] 

机构地区：[1]四川大学华西医院消化内科,成都610041

出　　处：《中华儿科杂志》2014年第5期328-332,共5页Chinese Journal of Pediatrics

摘　　要：目的 评价经内镜逆行胰胆管造影术（endoscopic retrograde cholangiopancreatography,ERCP）在儿童青少年胆胰疾病诊治中的安全性和疗效,并探讨儿童青少年胆胰疾病的特点.方法 回顾性分析2005至2012年期间于四川大学华西医院消化内镜中心接受ERCP诊治且年龄小于18岁的患儿的临床资料,并对诊治原因、诊治结果、治疗方法、手术相关并发症及随访结果进行统计分析.所有患儿均以成人十二指肠镜在全身麻醉或清醒镇静的状态下完成诊治,治疗方法包括内镜下乳头括约肌切开术、取石、胆管或胰管支架置入等手术.结果 68例患儿临床资料纳入研究,男29例,女39例,年龄5 ～17岁,平均年龄14.6岁,共完成102例次治疗性ERCP,操作成功率100％;其中全身麻醉状态下完成诊治13例（19％）,清醒镇静状态下接受诊治55例（81％）.诊治结果分别为：胆总管结石（n=37）54％、胰管结石（n=8）12％、胆总管狭窄（n=7）10％及其他良性疾病（n=16）24％.发生ERCP术后胰腺炎4例（4/102,4％）;术后腹痛、黄疸等症状缓解明显.结论 儿童青少年胆胰疾病主要为胆总管结石、胰管结石及胆胰管狭窄等良性病变;ERCP须由经验丰富的内镜医生完成操作,其对儿童青少年胆胰疾病的诊治具有安全性及有效性.Objective To evaluate the safety and efficacy of endoscopic retrograde cholangiopancreatography （ERCP） in children with pancreaticobiliary diseases and the characteristics of pancreaticobiliary disorders in children.Method Retrospective review was conducted on the data of patients younger than 18 years who underwent ERCP between 2005 and 2012 at West China Hospital.The indications,ERCP findings,ERCP procedures,complications,and clinical outcomes were evaluated.ERCP procedures were performed using standard duodenoscopes under general anaesthesia or sedation,which included all endoscopic treatments,such as endoscopic sphincteropapillotomy,stone extraction,stent treatment and so on.Result One hundred and two ERCPs were performed on 68 patients,and all the procedures were successfully completed in 100％ cases.There were 39 girls （57％）,and median age at time of procedure was 14.6 years （range,5-17 years）.General anesthesia and sedation were performed in 81％ and 19％ of procedures,respectively.The ERCP findings were classified as follows：bile duct stone（s） （n =37,54％）,pancreatic duct stone（s） （n =8,12％）,bile duct benign stricture （n =7,10％） and other nonmalignant pancreaticobiliary diseases （n =16,24％）.Four cases （4/102,prevalence 4％） were complicated with post-ERCP pancreatitis.Symptoms such as abdominal pain and jaundice were cured obviously after the procedures of ERCP were performed.Conclusion The main characteristics of pancreaticobiliary disorders in children were nonmalignant pancreaticobiliary diseases,such as bile duct stone,pancreatic duct stone,and bile/pancreatic duct benign stricture.When performed by well-trained endoscopists,ERCP is safe and effective in children.

关 键 词：儿童 青少年 胆囊疾病 胰腺疾病胆胰疾病 胰胆管造影术 内窥镜逆行 

分 类 号：R725.7[医药卫生—儿科]