浅谈影响ERCP操作的制约因素  

Factors restricting success of endoscopic retrograde cholangiopancreatography

作　　者：谢明征[1] 梁国刚[1] Ming-Zheng Xie Guo-Gang Liang(Department of Emergency Abdominal Surgery, the First Affiliated Hospital of Dalian Medical University, Dalian 116000, Liaoning Province, China)

机构地区：[1]大连医科大学附属第一医院腹部急症外科,辽宁省大连市116000

出　　处：《世界华人消化杂志》2017年第19期1735-1742,共8页World Chinese Journal of Digestology

基　　金：国家自然科学基金资助项目;No.81603428~~

摘　　要：内镜下逆行性胆胰管造影术(endoscopic retrograde cholangiopancreatography,ERCP)由于具有创伤小、时间短的优点,已在胆胰疾病的诊治方面具有举足轻重的作用,尤其在胆总管结石、胆囊切除术后的胆管复发结石的治疗方面已经成为了首选.但随着ERCP的广泛开展和认识的不断提高,大量研究显示局部解剖因素,尤其是十二指肠周围憩室、乳头嵌顿结石和乳头狭窄是影响ERCP操作成功的主要解剖因素.同时医护患三者间的配合也是影响ERCP操作成功的重要原因.本文系统复习相关文献资料,对ERCP操作失败的原因作一综述.Due to the advantages of minimal invasion and short duration, endoscopic retrograde cholangiopancreatography （ERCP） has an important role in the diagnosis and treatment of biliary and pancreatic diseases. Particularly, ERCP has became the first choice in the treatment of common bile duct stones after cholecystectomy and recurrent bile duct stones. However, with the increased understanding and extensive development of ERCP, a large number of studies show that local anatomical factors, especially periampullary diverticula （PAD）, impacted papillary stones, and papillary stenosis, are the main factors hindering the success of ERCP. Moreover, cooperation between patients, endoscopists and nurses are also an important reason for the successful operation of ERCP. This paper reviews the relevant literature to analyze the reasons for the failure of ERCP.

关 键 词：内镜下逆行性胆胰管造影术 操作失败 十二指肠壶腹周围憩室 乳头嵌顿性结石 乳头狭窄 

分 类 号：R657.4[医药卫生—外科学]