Billroth-Ⅱ式胃大部切除术后行经内镜逆行胰胆管造影的安全性分析  

Endoscopic retrograde cholangiopancreatography after Billroth-Ⅱ gastrectomy and its safety

作　　者：雷婷[1] 聂占国[1] 热合曼[1] 刘萍[1] 游云[1] 蒋丽丽[1] 张新[1] 

机构地区：[1]兰州军区乌鲁木齐总医院消化科,乌鲁木齐830000

出　　处：《临床肝胆病杂志》2016年第6期1152-1154,共3页Journal of Clinical Hepatology

摘　　要：目的探讨胃Billroth-Ⅱ式术后经内镜逆行胰胆管造影(ERCP)技术及其安全性。方法对2012年6月-2015年6月兰州军区乌鲁木齐总医院收治的胃Billroth-Ⅱ式术后43例患者行ERCP。结果 43例行ERCP的患者中插管成功39例(90.7%),插管失败2例(4.7%),并发消化道穿孔2例(4.7%)。39例患者中经ERCP诊断为胆总管结石31例(79.5%),其中3例行乳头括约肌切开术、28例行内镜下乳头球囊扩张术取石;诊断为胆管末端良性狭窄6例(15.4%),其中4例行单纯乳头球囊扩张术、2例行胆道塑料支架置入术;诊断为壶腹部肿瘤、胃癌肝门部转移各1例(2.6%),分别置入胆道金属支架、塑料支架。术后急性胰腺炎1例(2.6%)。结论对胃Billroth-Ⅱ式术后患者进行ERCP检查及治疗是安全、有效的,可在临床推广应用。Objective To investigate the safety of endoscopic retrograde cholangiopancreatography （ERCP） after Billroth - Ⅱ gastrectomy. Methods A total of 43 patients who were admitted to our hospital and underwent Billroth -Ⅱ gastrectomy froom June 2012 to June 2015 were enrolled and underwent ERCP. Results Of all 43 patients undergoing ERCP, 39 （90.7%） received successful intubation, 2 （4.7%） re- ceived failed intubation, and 2 （4. 7% ） experienced the complication of digestive tract perforation. Among the 39 patients who underwent ER- CP, 31 （79.5%） were diagnosed with conunon bile duct stones （3 underwent sphincterotomy and 28 underwent endoseopic papillary balloon dilation to remove stones）, 6 （15.4%） were diagnosed with benign stenosis at the end of bile duet （4 underwent papillary balloon dilation a- lone and 2 underwent biliary plastic stent implantation）, and 1 patient each （2.6%） was diagnosed with ampullary tumor and hepatic portal metastasis of gastric cancer and received implantation of metal and plastic stents, respectively. One patient （2. 6% ） experienced aeute pancre- atitis after surgery. Conclusion ERCP is safe and effective in patients after Billroth - Ⅱ gastrectomy and holds promise for clinical application.

关 键 词：胰胆管造影术 内窥镜逆行 胃肠吻合术 

分 类 号：R656.6[医药卫生—外科学]