内镜下乳头肌切开术后并发症的外科治疗  

Surgical management of the complications after endoscopic sphincterotomy

作　　者：贺冠海[1] 蔡阳[1] 钱锡元[1] 封光华[1] 应荣超[1] 徐铨[1] 贾鹏辉[1] 

机构地区：[1]杭州市第一人民医院普外科,310006

出　　处：《中华普通外科杂志》2002年第8期469-470,共2页Chinese Journal of General Surgery

摘　　要：目的探讨内镜下乳头肌切开术 (EST)后严重并发症的外科治疗。方法收治 11例EST术后并发严重出血、穿孔、胰腺炎患者 ,其中单纯出血 4例 ,单纯穿孔 3例 ,穿孔伴出血 3例 ,穿孔伴重症胰腺炎 1例。结果单纯出血 4例 ,单纯穿孔 3例 ,穿孔伴出血 1例患者均存活 ,穿孔伴出血2例及 1例穿孔伴重症胰腺炎患者死亡。结论早期诊断 ,积极手术是降低病死率的关键。对穿孔伴出血或重症胰腺炎的患者 ,强调充分引流胆汁、胰液 。ObjectiveTo review surgical management of the complications caused by iatrogenic endoscopic sphincterotomy(EST).MethodsEleven patients with complications of EST were surgically treated, including 4 patients with hemorrhage, 3 patients with perforation, 3 patients with perforation plus hemorrhage, and one patient with perforation plus severe pancreatitis. ResultsTwo patients with perforation plus hemorrhage and the patient with perforation plus severe pancreatitis died, other patients survived.ConclusionEarly diagnosis and surgical intervention was very important to lower the mortality. For patients suffering from perforation and hemorrhage or pancreatitis, it′s very important to make an unobstructed peritoneal drainage as well as other maneuvers.

关 键 词：括约肌切开术 内窥镜 术后 并发症 外科手术 EST 

分 类 号：R656.6[医药卫生—外科学]