不同插管技术在经内镜逆行胰胆管造影术插管困难时的应用研究进展  

Research progress in the application of different intubation techniques in difficult intubation of endoscopic retrograde cholangiopancreatography

作　　者：古泳新 祖洪亮 徐放 张增瑞 朱文钿[2] GU Yongxin;ZU Hongliang;XU Fang;ZHANG Zengrui;ZHU Wendian(The First School of Clinical Medicine,Guangdong Medical University,Guangdong Province,Zhanjiang524000,China;Department of General Surgery,the First People's Hospital of Zhaoqing,Guangdong Province,Zhaoqing526000,China)

机构地区：[1]广东医科大学第一临床医学院,广东湛江524000 [2]广东省肇庆市第一人民医院普外科,广东肇庆526000

出　　处：《中国当代医药》2023年第5期37-40,共4页China Modern Medicine

摘　　要：选择性胰胆管造影是经内镜逆行胰胆管造影术应用的基石。过长时间的胆管插管及反复的尝试插管会增加经内镜逆行胰胆管造影术后胰腺炎等并发症的风险,因此欧洲消化内镜协会对困难胆管插管进行了明确定义:胆管插管时间大于5 min,或插管次数大于5次,或导丝误入胰管次数大于1次或胰管显影。近年来医学界研究针对解决困难胆管插管这一难题提出多种方法,包括预切开技术、特殊的辅助仪器设备以及不同入路的穿刺技术。这些技术给患者带来较高临床疗效获益的同时也存在一定风险,因此根据实际病况选择不同的插管技术。本文主要针对不同插管技术在经内镜逆行胰胆管造影术困难插管应用的优势、插管成功率、并发症发生率及技术特点等做一综述,旨在为处理困难胆道插管提供有价值的建议。Selective cholangiopancreatography is the cornerstone of endoscopic retrograde cholangiopancreatography(ERCP).Prolonged intubation and repeated attempts to intubate will increase the risk of post-Endoscopic retrograde cholangiopancreatography pancreatitis.The European Society of gastroendoscopy has put forward a clear definition of difficult bile duct intubation:the time of bile duct intubation is more than 5 minutes,or the times of intubation is more than 5,or the times of guide wire entering the pancreatic duct by mistake is more than 1,or the pancreatic duct is developed.In recent years,the medical community has proposed various methods to solve the problem,including precut sphincterotomy technology,special auxiliary instruments and equipment,and puncture technology through different approaches.These techniques bring not only excellent clinical effect but also certain risks to patients.Therefore,different intubation techniques are selected according to the actual condition.This article mainly introduces the advantages,intubation success rates,complication rates and technical characteristics of different intubation techniques in difficult intubation of ERCP.It aims to provide valuable suggestions for dealing with difficult biliary intubation.

关 键 词：经内镜逆行胰胆管造影术 困难插管 预切开 治疗 

分 类 号：R615[医药卫生—外科学]