钛夹辅助在十二指肠憩室边缘乳头插管困难患者中的应用  

Application of titanium clip assisted in patients with difficulty in duodenal diverticulum marginal nipple intubation

作　　者：李艳艳[1] 刘金材[1] 李江涛[1] 杨谦[1] LI Yanyan;LIU Jincai;LI Jiangtao;YANG Qian(Department of Gastroenterology,Jiujiang No.1 People's Hospital,Jiangxi Province,Jiujiang332000,China)

机构地区：[1]江西省九江市第一人民医院消化内科,江西九江332000

出　　处：《中国当代医药》2023年第12期54-57,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202140315)。

摘　　要：目的探讨十二指肠憩室边缘乳头插管困难患者行内镜逆行胰胆管造影术(ERCP)时予以钛夹辅助选择性胆管插管的应用和可行性。方法选取2020年7月至2022年3月九江市第一人民医院消化内科收治的38例胆总管结石伴十二指肠憩室边缘乳头胆管插管困难患者作为研究对象,按照随机数字表法将其分为观察组(19例)和对照组(19例)。观察组患者予以钛夹辅助选择性胆管插管,对照组患者仍尝试传统技术插管,直至插管成功或放弃。观察两组患者的插管成功率、插管时间、术后24 h血清淀粉酶水平及手术相关并发症总发生率。结果观察组患者的插管时间短于对照组,差异有统计学意义(P<0.05);两组患者的插管成功率比较,差异无统计学意义(P>0.05)。观察组患者的术后24 h血清淀粉酶水平低于对照组,差异有统计学意义(P<0.05)。两组患者的术后高淀粉酶血症发生率比较,差异无统计学意义(P>0.05)。观察组患者的并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论十二指肠憩室边缘乳头胆管插管困难患者ERCP时予以钛夹辅助选择性胆管插管,能够缩短十二指肠憩室边缘乳头插管困难患者的插管时间,并降低其并发症发生风险。Objective To investigate the application and feasibility of titanium clip assisted selective bile duct intubation during endoscopial retrograde cholangiopancreatography(ERCP)in patients with difficulty in duodenal diverticulum marginal nipple intubation.Methods A total of 38 patients with common bile duct stones and difficult selective biliary cannulation at the edge of duodenal diverticulum treated in the Department of Gastroenterology of Jiujiang No.1 People's Hospital from July 2020 to March 2022 were selected as the research objects.According to the random number table method,they were divided into the observation group(19 cases)and the control group(19 cases).Patients in the observation group were assisted with selective bile duct intubation with titanium clip assisted,while patients in the control group continued to try traditional intubation until the intubation was successful or abandoned.The success rate of intubation,intubation time,serum amylase level 24 h after surgery and the total incidence of surgery-related complications were observed in the two groups.Results The intubation time of observation group was shorter than that of control group,and the difference was statistically significant(P<0.05).There was no significant difference in the success rate of intubation between the two groups(P>0.05).The level of serum amylase 24 h after operation in observation group was lower than that in control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of postoperative hyperamylasemia between the two groups(P>0.05).The total incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion In patients with peripheral papillary bile duct intubation difficulties of duodenal diverticulum,selective bile duct intubation assisted by titanium clips during ERCP can shorten the intubation time of patients with peripheral papillary duct intubation difficulties

关 键 词：十二指肠憩室 内镜逆行胰胆管造影术 选择性胆管插管困难 钛夹辅助 

分 类 号：R657.4[医药卫生—外科学]