内镜逆行胰胆管造影术胆管插管困难病例辅助插管技术研究进展  

Research Progress of Assistive Intubation Techniques for Difficult Biliary Cannulation during Endoscopic Retrograde Cholangiopancreatography

作　　者：钱晶瑶 李文[2] 

机构地区：[1]天津海滨人民医院消化科,天津300280 [2]天津市人民医院内镜中心,天津300121

出　　处：《医学综述》2016年第15期3010-3015,共6页Medical Recapitulate

摘　　要：内镜逆行胰胆管造影术(ERCP)是一项重要的治疗性内镜技术,而胆管插管困难和ERCP后胰腺炎仍是这一技术的难点。长时间的反复插管尝试会增加ERCP后胰腺炎的风险。因此,掌握各种新型插管技术在提高插管成功率和规避ERCP后胰腺炎中起到极其重要的作用。该文主要阐述和分析在最初常规方法插管尝试失败后,能够提高胆管插管成功率和降低ERCP后胰腺炎发生率的技术,包括导丝引导插管技术、括约肌切开刀辅助导丝插管技术、胰管导丝留置法(双导丝法)、胰管支架术、针状刀预切开术(包括经针状刀造瘘口插管)、经胰管括约肌预切开术等。Endoscopic retrograde cholangiopanereatography（ERGP） is one ofthe most technically chal- lenging procedures in therapeutic endoscopy; difficulties in biliary cannulation and post-ERCP pancreatitis are still significant problems. Repeated and prolonged attempts at cannulation increase the risk of post-procedure pancreatitis. Therefore, cannulation technique plays a pivotal role in successful cannulation and prevention of post-procedure pancreatitis. Here presents and discusses the techniques that can be used for achieving biliary cannulation after an initial failure and for minimizing the risk of pancreatitis, including guide wire assisted technique, needle knife precutting, trans-pancreatic sphincterotomy, and pancreatic stenting.

关 键 词：胰腺炎 内镜逆行胰胆管造影术 胆管插管困难 

分 类 号：R657.51[医药卫生—外科学]