ERCP联合EST治疗胆总管结石的术后远期并发症  

Long-term complications post endoscopic retrograde cholangiopancreatography combined with endoscopic sphincterotomy for choledocholithiasis

作　　者：陆晔[1] 刘皓慈[1] 陈胜[1] 吴卫泽[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院外科,上海200025

出　　处：《外科理论与实践》2015年第2期116-120,共5页Journal of Surgery Concepts & Practice

摘　　要：目的：评价内镜逆行胰胆管造影术（ERCP）联合内镜下括约肌切开术（EST）术后远期并发症的发生率,检验十二指肠憩室及胆囊切除是否影响远期并发症发生。方法：在我院ERCP手术数据库中选取2009年至2012年成功接受ERCP联合EST治疗的胆总管结石病人进行电话随访,随访内容包括病人术后胆道系统临床症状以及远期并发症发生与否。结果：在172例成功进行ERCP的病人中,术后27~71个月胆总管结石的复发率为25.0%（43/172）,急性胆管炎发生率为8.1%（14/172）。以上两类并发症发生与年龄无关（P〉0.05）。ERCP术前存在十二指肠憩室以及术前行胆囊切除术并不影响术后并发症发生率（P〉0.05）。结论：胆总管结石复发及急性胆管炎是ERCP联合EST术后的主要远期并发症。Objective To determine the incidence of long-term complications post endoscopic retrograde cholangiopancreatography（ERCP） combined with endoscopic sphincterotomy（EST）, and to examine whether duodenal diverticu-lum or cholecystectomy before-ERCP would affect long-term complications. Methods We got access to the database of ERCP from our hospital and recruited the patients who had successfully experienced ERCP ＋EST between 2009 and 2012.Patients were taken through a standard questionnaire via telephone interview, and the information whether biliary symptoms recurred and whether any long-term complications occurred post-surgery was obtained. Results In 172 successful ERCP cases, recurrent choledocholithiasis was found in 43（25%） cases 27-71 months post-surgery, while acute cholangitis in 14（8.1%）. No significant difference was observed in the incidence of complications when patients were grouped by age（P 0.05）. Moreover, it was found that duodenal diverticulum diagnosed pre-surgery was not associated with post-ERCP long-term complications（ P0.05）. Whether patients had cholecystectomy was not a significant contributor for long-term complication, either（P0.05）. Conclusions Recurrent choledocholithiasis and acute cholangitis are the main long-term complications following ERCP combined with EST.

关 键 词：胆总管结石 内镜逆行胰胆管造影术 内镜括约肌切开术 

分 类 号：R657.4[医药卫生—外科学]