胰管支架在内镜逆行胆胰管造影中的应用价值  

Clinical value ofpancreatic duct stent in endoscopic retrograde cholangiopancreatography

作　　者：王建荣 缪林[2] 张秀华[2] 李全朋[2] 蒋国斌[2] 

机构地区：[1]泰州市第4人民医院消化科,江苏泰州225300 [2]南京医科大学第2附属医院消化医学中心,江苏南京210011

出　　处：《临床消化病杂志》2015年第6期360-363,共4页Chinese Journal of Clinical Gastroenterology

摘　　要：[目的]探讨胰管支架在选择性胆管插管的内镜逆行胆胰管造影术(ERCP)中的应用价值。[方法]将114例选择性胆管插管的ERCP患者随机分为支架组(51例)和非支架组(63例),支架组在插入胰管后行经胰管胆胰管隔膜切开术后常规置入胰管支架之后继续下一步治疗,非支架组在进入胰管后行经胰管胆胰管隔膜切开术后再行选择性胆管插管及下一步治疗,观察2组患者ERCP后胰腺炎(PEP)的发生率及插管成功率。[结果]支架组PEP发生率1.96%(1/51)、插管成功率98.04%(50/51),非支架组PEP发生率14.28%(9/63)、插管成功率84.13%(53/63),2组患者PEP发生率及插管成功率差异均有统计学意义(P<0.05)。[结论]选择性胆管插管的ERCP患者在插入胰管后置入胰管支架可降低其PEP的发生率,提高插管成功率。[Objective]To investigate the clinical value of the selective pancreatic duct stent incubation cannula in endoscopic retrograde cholangiopancreatography（ERCP）. [Methods]The total of 114 cases treated with selective bile duct cannulation in patients with ERCP were randomly divided into stent group（51 cases）and non-stent group（63 cases）. Patients in the stent group were treated with pancreatic stent placement after theafter the conventional diaphragm cut. Patients in non-stent group were treated with the bile duct diaphragm cut and biliary selective catheterization. The incidence of PEP and intubation success rate in these two groups were observed.[Results]The incidence of PEP 1.96%（1/51）,intubation success rate in stent group was 98.04%（50/51）. The incidence of PEP was 14.28 %（9/63） ,success rate of intubation was 84.13 %（53/63）in non-stent group. The incidence of PEP and intubation success rate between the two groups was significantly（P〈0.05）. A total of 11 cases of patients with unsuccessful selective catheterization were successfully treated with nipple needle knife fenestration（NKF）deep biliary cannulation. [Conclusion]Selective bile duct cannulation in patients with ERCP during pancreatic duct stent placement can reduce the incidence and severity of PEP,and can improve the success rate of intubation.

关 键 词：逆行胰胆管造影 胰管支架 胰腺炎 

分 类 号：R57[医药卫生—消化系统]