双导丝插管技术与经乳头括约肌预切开术在困难性胆管插管ERCP中的应用  

The application of pre- incision of double guidewire cannulation and sphincterotomy in difficult biliary cannulation for ERCP

作　　者：孙竹峰[1] 黄东平[1] 赵嘉晶[1] 黄建伟[1] 周庚仁[1] 

机构地区：[1]上海市普陀区人民医院外科,上海200060

出　　处：《临床和实验医学杂志》2016年第15期1487-1489,共3页Journal of Clinical and Experimental Medicine

基　　金：上海市卫生和计划生育委员会中医药科研基金课题(2014LQ054A)

摘　　要：目的探讨双导丝插管技术与经乳头括约肌预切开术在困难性胆管插管内镜逆行胰胆管造影(ERCP)中的应用。方法选择105例困难性胆管插管ERCP患者,其中45例采用双导丝技术,29例采用经乳头括约肌预切开术,31例采用经胰管预切开术。比较插管成功率和并发症发生率。结果三种技术插管成功率无统计学差异,成功插管时间也无统计学差异(P>0.05)。经乳头括约肌预切开术的术后轻型胰腺炎发生率显著高于双导丝技术和经胰管预切开术。经胰管预切开术的出血发生率显著高于双导丝技术和经乳头括约肌预切开术。三组穿孔的发生率均为0。结论双导丝插管术方法简单、术后并发症发生率低,可作为优先选择的困难性胆管插管ERCP的辅助插管技术。Objective To explore the application of pre - incision of double guidewire cannulation and sphincterotomy in difficult biliary cannulation of endoscpic retrograde cholangiopancreatography（ERCP）. Methods A total of 105 cases of difficult bile duct intubation for ERCP were collected for this study. 45 cases were applied with double guide wire technique,29 patients were using pre - sphincterotomy incision and 31 cases were using pre - incision pancreatic duct. The successful rate of intubation and incidence rate of complications were calculated. Results The difference in successful rate of intubation among three techniques was not statistically significant,and the difference in successful intubation time was not significant among three techniques. The incidence of postoperative sphincterotomic pancreatitis in patients with pre - sphincterotomy incision was significantly higher than that of double guidewire technique and pre - incision pancreatic duct. The incidence of bleeding in pre - duct incision was significantly higher than that of double guidewire technique and pre - sphincterotomy incision. Among these three techniques,the in-cidence of perforation was 0% . Conclusion The double guide wire cannulation method is simple,with low complication rate,hence it can be used as the first choice for difficult bile duct intubation for ERCP assisted intubation technique.

关 键 词：ERCP 困难性单管插管 双导丝插管技术 乳头括约肌预切开术 

分 类 号：R657.4[医药卫生—外科学]