经口胆胰管镜联合内镜逆行胰胆管造影经十二指肠乳头胆囊息肉切除的疗效及安全性分析  

Efficacy and safety of endoscopic retrograde cholangiopancreatography combined with oral cholangiopancreatography in the treatment of duodenal papilla cholecystectomy

作　　者：陶丽莹 王宏光[1] 郭庆梅[1] 郭享[1] 朴连玉 杨沐雨 于泳 阮丽斌[1] 谷建彬[1] 陈思 杜迎亭 盖秀英[1] 郭思捷 TAO Liying;WANG Hongguang;GUO Qingmei;GUO Xiang;PIAO Lianyu;YANG Muyu;YU Yong;RUAN Libin;GU Jianbin;CHEN Si;DU Yingting;GAI Xiuying;GUO Sijie(Department of Gastroenterology,Jilin People’s Hospital,Jilin Jilin 132001,China;Department of Science and Education,Jilin People’s Hospital,Jilin Jilin 132001,China;Department of Pathology,Jilin People’s Hospital,Jilin Jilin 132001,China)

机构地区：[1]吉林市人民医院消化内镜科,吉林吉林132001 [2]吉林市人民医院科教科,吉林吉林132001 [3]吉林市人民医院病理科,吉林吉林132001

出　　处：《临床肝胆病杂志》2025年第3期513-517,共5页Journal of Clinical Hepatology

基　　金：吉林市科技创新发展计划项目(20230406148)。

摘　　要：目的探讨通过内镜逆行胰胆管造影(ERCP)联合经口胆胰管镜行经十二指肠乳头胆囊息肉切除治疗的可行性和安全性。方法回顾性分析2022年5月—2024年6月于吉林市人民医院消化内镜中心采用ERCP联合经口胆胰管镜行经十二指肠乳头胆囊息肉切除的8例胆总管结石合并胆囊息肉患者的临床资料,收集手术成功率和胆囊息肉清除技术成功率,胆囊管超选方式、整体手术时间、胆囊息肉切除时间、手术并发症等指标。结果手术成功率及胆囊息肉切除技术成功率为100%,其中3例患者通过导丝引导直视进入胆囊,5例通过经口胆胰管镜直接进入胆囊;整体手术时间为(51.88±12.34)min,胆囊息肉切除时间为(23.13±10.94)min;胆囊息肉病变直径为2~8 mm;病理结果为3例炎性息肉,1例腺瘤性息肉,4例胆固醇性息肉;术中及术后无并发症,术后随访2~27个月,胆囊无息肉复发。结论经口胆胰管镜在内镜下经十二指肠乳头胆囊息肉切除的临床应用,技术上相对安全可行。Objective To investigate the feasibility and safety of endoscopic retrograde cholangiopancreatography(ERCP)combined with oral cholangiopancreatography in the treatment of major duodenal papilla gallbladder polyps.Methods A retrospective analysis was performed for the clinical data of eight patients with choledocholithiasis and gallbladder polyps who underwent ERCP and combined with oral cholangiopancreatography for major duodenal papilla cholecystectomy in Center of Digestive Endoscopy,Jilin People’s Hospital,from May 2022 to June 2024,and related data were collected,including the success rate of surgery,the technical success rate of gallbladder polyp removal,the superselective method of cystic duct,the time of operation,the time of gallbladder polyp removal,and surgical complications.Results Both the success rate of surgery and the technical success rate of gallbladder polyp removal reached 100%,and of all eight patients,three patients used guide wire to enter the gallbladder under direct view,while five patients received oral cholangiopancreatography to directly enter the gallbladder.The time of operation was 51.88±12.34 minutes,and the time of gallbladder polyp removal was 23.13±10.94 minutes.The diameter of gallbladder polyp was 2—8 mm,and pathological examination showed inflammatory polyps in three patients,adenomatous polyps in one patient,and cholesterol polyps in four patients.There were no complications during or after surgery.The patients were followed up for 2—27 months after surgery,and no recurrence of gallbladder polyp was observed.Conclusion Oral cholangiopancreatography is technically safe and feasible in endoscopic major duodenal papilla cholecystectomy.

关 键 词：胆囊疾病 息肉 肝胰管壶腹 胰胆管造影术 内窥镜逆行 经口胆胰管镜 

分 类 号：R65[医药卫生—外科学]