导向型针形刀在内镜下乳头括约肌切开术中的应用  

Application of wire-guided needle-knife to endoscopic papillosphincterotomy

作　　者：邓小明[1] 张丰深[1] 孙海[1] 杨星[1] 吴国栋 李志强[1] 唐军[1] 

机构地区：[1]解放军324医院肝胆外科,重庆400020

出　　处：《西南国防医药》2016年第5期480-482,共3页Medical Journal of National Defending Forces in Southwest China

基　　金：重庆市卫生局医学科研计划面上项目(2011-2-589)

摘　　要：目的探讨导向型针形刀在内镜下乳头括约肌切开术（EST）中应用技巧和价值。方法对2011年6月~2013年6月EST困难的34例患者,采用自行设计研制的导向型针形刀切开,观察治疗效果和近期并发症。结果 34例均顺利完成有效切开,切开时间5~10 min,平均6.8 min。术中2例出现少量渗血,经电凝止血后效果好。术后并发高淀粉酶血症1例,经保守治疗治愈;无术后出血、胰腺炎、消化道穿孔等严重并发症。结论导向型针形刀作为弓形刀的补充工具,降低了EST的风险,值得临床推广应用。Objective To explore operation skills and values of wire-guided needle-knife in endoscopic sphincterotomy（EST）.Methods Between June 2011 and June 2013, 34 cases that could not undergo standard sphincterotomy with clever knife were treated by wire-guided needle-knife. Observation was made in the therapeutic effects and the recent postoperative complications. Results All the operations were performed successfully. The time to cut-open was 5 to 10 minutes, and the average was 6.8 minutes. Mild bleeding occurred during the operation in two patients, which was staunched by the electrocoagulation. After the operation,hyperamylasemia occurred in one patient who was cured by conservative treatment. There were no severe postoperative complications like bleeding, pancreatitis, and enteron perforation, etc. Conclusion Wire-guided needle-knife is a valuable adjunct tool to conventional techniques, which reduces the risk of EST and is worthwhile to be promoted.

关 键 词：内镜 乳头括约肌 切开 导向型 针形刀 

分 类 号：R657.4[医药卫生—外科学]