ERCP在胆胰疾病微创治疗中的有效性及安全性  

Efficacy and safety of ERCP in minimally invasive treatment for biliary and pancreatic diseases

作　　者：郭世龙 杨潇[1] 胡欢欢 杨梁 周文富 丛魁武 张雨胜 李英锋[1] Guo Shilong;Yang Xiao;Hu Huanhuan;Yang Liang;Zhou Wenfu;Cong Kuiwu;Zhang Yusheng;Li Yingfeng(Department of Hepatobiliary and Pancreatic Surgery,Qianjiang Central Hospital,Qianjiang 433100,China)

机构地区：[1]湖北省潜江市中心医院肝胆胰外科,433100

出　　处：《中华肝脏外科手术学电子杂志》2023年第2期216-220,共5页Chinese Journal of Hepatic Surgery(Electronic Edition)

摘　　要：目的探讨ERCP在胆胰疾病微创治疗中的有效性及安全性。方法回顾性分析2020年1月至2022年3月在潜江市中心医院接受ERCP治疗的177例胆胰疾病患者临床资料。患者均签署知情同意书,符合医学伦理学规定。其中男75例,女102例;平均年龄(62±13)岁。胆道结石151例,胆道恶性梗阻15例,良性梗阻5例,胆漏4例,胰管结石2例。观察ERCP治疗胆胰疾病的有效率和术后并发症发生率。结果ERCP治疗成功率为98.3%(174/177)。术后并发症发生率为3.4%(6/177),其中术后急性胰腺炎3例;十二指肠乳头出血2例;肠穿孔1例,该例患者术后死亡。151例胆总管结石中,行乳头球囊扩张术(EPBD)131例,乳头切开术(EST)20例,结石清除率为97.3%(147/151)。15例胆道恶性梗阻中,ERCP手术失败1例,改为PTCD减黄;2例恶性肿瘤ERCP下病理活检和内镜下鼻胆管引流术减黄后行根治性胰十二指肠切除术;其余12例行胆道支架置入。5例胆道良性梗阻均成功实施ERCP球囊扩张,置入胆道支架引流。4例胆漏ERCP引流后保守治疗痊愈。2例胰管结石ERCP取石后置入胰管支架,患者腹痛明显缓解。结论ERCP治疗胆胰疾病安全、有效,规范的操作和严密的围手术期处理可尽可能减少术后并发症。Objective To evaluate the efficacy and safety of ERCP in minimally invasive treatment of biliary and pancreatic diseases.Methods Clinical data of 177 patients with biliary and pancreatic diseases treated with ERCP in Qianjiang Central Hospital from January 2020 to March 2022 were retrospectively analyzed.The informed consents of all patients were obtained and the local ethical committee approval was received.Among them,75 patients were male and 102 female,aged(62±13)years on average.151 patients were diagnosed with bile duct stones,15 cases of malignant biliary obstruction,5 cases of benign obstruction,4 cases of bile leakage and 2 cases of pancreatic duct stones.Clinical efficacy and the incidence of postoperative complications of ERCP for biliary and pancreatic diseases were observed.Results The success rate of ERCP was 98.3%(174/177).The incidence of postoperative complications was 3.4%(6/177),including 3 cases of postoperative acute pancreatitis,2 cases of duodenal papilla hemorrhage and 1 case of intestinal perforation,who died after operation.Among 151 patients with choledocholithiasis,131 cases underwent EPBD and 20 cases received endoscopic sphincterotomy(EST).The stone clearance rate was 97.3%(147/151).Among 15 cases of malignant biliary obstruction,ERCP was not successfully performed in 1 case who was converted to PTCD for reduction of jaundice.2 cases with malignant tumors underwent radical pancreaticoduodenectomy following pathological biopsy under ERCP and endoscopic nasobiliary drainage jaundice reduction.The remaining 12 cases were treated with biliary stent implantation.In 5 cases with benign biliary obstruction were successfully treated with ERCP balloon dilatation and biliary stent drainage.4 cases with bile leakage were cured by conservative treatments after ERCP drainage.Pancreatic duct stones in 2 cases were removed by ERCP and pancreatic duct stents were implanted,and the patients'abdominal pain was significantly relieved.Conclusions ERCP is a safe and efficacious treatment for biliary and

关 键 词：胰胆管造影术 内窥镜逆行 胆胰疾病 外科手术 微创性 治疗结果 安全性 

分 类 号：R657.4[医药卫生—外科学]