超声内镜引导下对接技术治疗经内镜逆行胰胆管造影术失败的恶性梗阻性黄疸的疗效研究  

EUS-guided rendezvous for malignant obstructive jaundice after failured ERCP

作　　者：张皞 黄平[2] 张筱凤[2] 吕文[2] 范震[2] 黄海涛[2] 楼颂梅[2] 王霞[2] Hao Zhang;Ping Huang;Xiao-feng Zhang;wen Lü;Zhen Fan;Hai-tao Huang;Song-mei Lou;Xia Wang(Department of Gastroenterology, Xixi Hospital, Hangzhou, Zhejiang 310023, China;Department of Gastroenterology, the First People’s Hospital, Hangzhou, Zhejiang 310006, China)

机构地区：[1]浙江省杭州市西溪医院内科,浙江杭州310023 [2]浙江省杭州市第一人民医院消化内科,浙江杭州310006

出　　处：《中国内镜杂志》2017年第7期22-25,共4页China Journal of Endoscopy

基　　金：杭州市科技发展计划项目(No:20140733Q11)

摘　　要：目的探讨超声内镜引导下对接技术(EUS-RV)治疗经内镜逆行胰胆管造影术(ERCP)失败的恶性梗阻性黄疸的疗效。方法 12例恶性梗阻性黄疸患者在ERCP不成功后改为EUS-RV治疗。观察其操作成功率、术后1周及1个月肝功能指标恢复情况、并发症发生率、住院时间及患者生存期。结果 12例患者均通过超声内镜穿刺成功,经胃穿刺者8例,经十二指肠穿刺4例,成功率为100.00%;术后1周较术前、术后1个月较术后1周肝功能指标差异有统计学意义(P<0.05);并发出血1例,经保守治疗后改善,并发症发生率8.33%;所有患者住院时间为(20.68±5.76)d;平均生存期为224 d。结论 EUS-RV创伤小、疗效好,可作为ERCP失败的恶性梗阻性黄疸患者的替代治疗。Objective To study the therapeutic effect of EUS-guided rendezvous(EUS-RV)when ERCP failed in patients with malignant obstructive jaundice.Methods12cases of malignant obstructive jaundice patients were underwent EUS-RV after unsuccessful ERCP.The operation success rate,liver function recovery1week and1month after operation,complication rates,hospital stay and patient survival were observed.Results All12patients were successfully operated and placed stents by endoscopic ultrasound puncture following by ERCP:8patients by the stomach,4patients by duodenum,the operation success rate was100.00%;There were significant difference between the liver function recovery of preoperative and postoperative one week or postoperative one week and postoperative one month(P<0.05).1bleeding occurred and were improved after conservative treatment,the complications rate was8.33%;the hospital stay was(20.68±5.76)d;the average survival time of patients was224d.Conclusion EUS-guided rendezvous may be the alternative treatment due to the diminutive trauma and good effect when ERCP failed in patients with malignant obstructive jaundice.

关 键 词：恶性梗阻性黄疸 超声内镜引导下对接技术 经内镜逆行胰胆管造影术失败 

分 类 号：R657.4[医药卫生—外科学]