非医源性胆道出血的内镜下治疗  

Experience of Endoscopic Treatment for Non-iatrogenic Hemobilia

作　　者：陆磊[1] 金旭文 陆峰[1] 王翬[1] 

机构地区：[1]上海市中西医结合医院微创外科,上海200082

出　　处：《中国微创外科杂志》2016年第6期522-524,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨非医源性胆道出血在内镜下治疗的可行性及效果。方法 2010年12月～2015年3月对26例经内镜证实的非医源性胆道出血,根据出血原因及症状严重程度分别采取内镜鼻胆管引流术（endoscopic nasobiliary drainage,ENBD）、胆道支架置入术和胆道射频消融术（radio frequency ablation,RFA）进行治疗。结果 26例中胆道结石15例,胆道感染8例,肝门部胆管癌3例。内镜下可见十二指肠乳头新鲜出血18例,8例在胆管内取出血凝块。26例均行内镜下治疗,其中15例行ENBD,8例行胆道支架置入术,3例行RFA。术后出血停止,胆道引流通畅,症状明显缓解。结论非医源性胆道出血可经内镜治疗,内镜下不仅可以明确诊断,解除胆道梗阻,同时可以进行止血治疗。Objective To discuss the feasibility and effect of endoscopic treatment for non-iatrogenic biliary tract bleeding.Methods Clinical data of 26 cases of non-iatrogenic biliary tract hemorrhage confirmed by endoscopy were reviewed. According to the causes of bleeding and severity of symptoms,endoscopic nasobiliary drainage（ ENBD）,biliary stenting,or biliary radio frequency ablation（ RFA） were applied. Results Among the 26 cases,there were 15 cases of biliary stones,8 cases of biliary tract infection,and 3 cases of hilar cholangiocarcinoma. Under endoscopy duodenal papilla fresh bleeding was seen in 18 cases,8 of which had blood clots in the bile duct. All the cases underwent endoscopic therapy,including 15 cases of ENBD,8 cases of biliary stenting,and 3cases of biliary RFA. The bleeding was stopped in all the patients postoperatively,with unobstructed biliary drainage and relieved symptoms. Conclusions The non-iatrogenic bile duct hemorrhage can be treated by endoscopic treatment. Endoscope can not only be applied to diagnose and relieve biliary obstruction,but also be used to stop the bleeding.

关 键 词：胆道出血 内镜 胰胆管造影术 

分 类 号：R657.4[医药卫生—外科学]