内镜超声引导胆总管十二指肠吻合术治疗解剖结构异常胆道梗阻的疗效观察  

Efficacy of endoscopic ultrasound-guided choledochoduodenectomy in the treatment of biliary obstruction with abnormal anatomical structure

作　　者：吴文荣 苏光里 邱顺平 徐阳 何健鹏 WU Wenrong;SU Guangli;QIU Shunping;XU Yang;HE Jianpeng(Department of General Surgery,Shangrao People's Hospital,Shangrao,Jiangxi,334000,China;Digestive Endoscopy Center,Shangrao People's Hospital,Shangrao,Jiangxi,334000,China;Department of Ultrasound Medicine,Shangrao People's Hospital,Shangrao,Jiangxi,334000,China)

机构地区：[1]上饶市人民医院普外科,江西上饶334000 [2]上饶市人民医院消化内镜中心,江西上饶334000 [3]上饶市人民医院超声医学科,江西上饶334000

出　　处：《当代医学》2023年第17期107-110,共4页Contemporary Medicine

基　　金：江西省卫生健康委科技计划项目(202212746)。

摘　　要：目的探讨内镜超声引导胆总管十二指肠吻合术(EUS-CDS)治疗解剖结构异常胆道梗阻的疗效。方法选取2021年1—12月本院收治的60例胃肠手术所致解剖结构异常的胆道梗阻患者作为研究对象,采用随机数字表法分为对照组与观察组,各30例。对照组行传统内镜逆行胰胆管造影术(ERCP)治疗,观察组行EUS-CDS治疗,比较两组治疗前后血清胆红素指标[总胆红素(TBIL)、直接胆红素(DBIL)]、手术时间、引流时间、住院时间、手术成功率及并发症发生情况。结果治疗前,两组TBIL、DBIL水平比较差异无统计学意义;治疗后,两组TBIL、DBIL水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组手术时间、引流时间、住院时间均明显短于对照组,差异有统计学意义(P<0.05)。观察组手术成功率为96.67%,明显高于对照组的70.00%,差异有统计学意义(P<0.05)。观察组并发症发生率为3.33%,明显低于对照组的26.67%,差异有统计学意义(P<0.05)。结论EUS-CDS治疗解剖结构异常胆道梗阻疗效显著,可作为一线治疗方式替代传统ERCP,具有创伤性小、恢复速度快等优点,可提高手术成功率,降低并发症发生率。Objective To investigate the efficacy of endoscopic ultrasound-guided choledochoduodenectomy(EUS-CDS)in the treatment of biliary obstruction with abnormal anatomical structure.Methods 60 patients with biliary obstruction with abnormal anatomical structure caused by gastrointestinal surgery in our hospital from January 2021 to December 2021 were selected as the research subjects,and they were divided into the control group and the observation group according to the random number table method,with 30 cases in each group.The control group underwent traditional endoscopic retrograde cholangiopancreatography(ERCP),the observation group underwent EUS-CDS,the serum bilirubin indexes(total bilirubin[TBIL],direct bilirubin[DBIL])before and after treatment,operation time,drainage time,hospitalization time,operation success rate and complications were compared between the two groups.Results Before treatment,there were no significant differences in TBIL and DBIL levels between the two groups;after treatment,the levels of TBIL and DBIL of the two groups were lower than those before treatment,and the observation group was lower than the control group,the differences were statistically significant(P<0.05).The operation time,drainage time and hospitalization time in the observation group were significantly shorter than those in the control group,and the differences were statistically significant(P<0.05).The success rate of operation in the observation group was 96.67%,which was significantly higher than 70.00%in the control group,the difference was statistically significant(P<0.05).The incidence of complications in the observation group was 3.33%,which was significantly lower than 26.67%in the control group,and the difference was statistically significant(P<0.05).Conclusion EUS-CDS is effective in the treatment of biliary obstruction with abnormal anatomical structure,it can be used as first-line treatment to replace the traditional ERCP,it has the advantages of less trauma and fast recovery in the palliative treatment of biliar

关 键 词：内镜超声引导 胆总管十二指肠吻合术 解剖结构异常 胆道梗阻 

分 类 号：R657.4[医药卫生—外科学]