胰源性黄疸术前直接胆道造影致胆道外科急症的原因与处理  

Causes and management of acute biliary complications due to pre-operative direct cholangiography in pancreatic jaundice

作　　者：刘子文[1] 廖泉[1] 李佳忆[1] 赵玉沛[1] 

机构地区：[1]中国医学科学院,中国协和医科大学,北京协和医院,北京100730

出　　处：《中国实用外科杂志》2003年第6期338-339,共2页Chinese Journal of Practical Surgery

摘　　要：目的　分析胰源性黄疸术前行直接胆道造影过程中发生并发症的原因 ,探讨其处理方法。方法　对1997～ 2 0 0 2年收治的 110例因胰腺疾病导致梗阻性黄疸病人术前行直接胆道造影发生急性胆道并发症的临床资料进行回顾性分析。结果　行PTCD检查 42例 ,ERCP 5 9例 ,行两种检查者 9例。总急性胆道并发症 10例( 9 0 9% ) ,PTCD组急性胆道并发症 7例 ( 13 73 % ) ,急性胆管炎 4例 ,胆道出血 2例 ,胆汁性腹膜炎 1例 ,死亡 1例。ERCP组急性胆道并发症 3例。结论　胰源性黄疸行直接胆道造影检查虽有一定的并发症发生 ,但合理的选择适应证 ,严格操作规范 ,对术后病人严密观察 ,积极的保守治疗可避免和治愈并发症。Objective To analyze causes and management of complications due to direct cholangiography of pancreatic jaundice.Methods Retrospectively analyze 110 pancreatic obstructive jaundice patients who received pre-operative direct cholangiography in our hospital from January 1997 to December 2002 Results 42 cases received PTCD, 59 cases received ERCP, and 9 patients received both PTCD and ERCP. The overall acute biliary complications occurred in 10 cases(9 09%). In PTCD group,there were 7 cases of acute biliary complication,4 cases of acute cholangitis, 2 cases of bile duct hemorrhage, and 1 case of bile leakage resulting in biliary peritonitis and 1 death. In ERCP group,there were 2 cases of acute cholangitis and 1 case of hemorrhage. Conclusion Direct cholangiography is an invasive procedure, hence selection according to reasonable indications and careful operation may exclude the above mentioned complications. Most complications may be managed conservatively. Direct cholangiography is an important and safe option in diagnosis and treatment of biliary drainage in patients with pancreatic jaundice.

关 键 词：胰源性黄疸术 直接胆道造影 胆道 外科急症 原因 处理 

分 类 号：R657.4[医药卫生—外科学]