经内镜逆行胰胆管造影916例临床分析

目的探讨经内镜逆行胰胆管造影(ERCP)在诊断及治疗胰胆道疾病中的应用价值及安全性,寻找提高ERCP操作成功率以及防止或减少并发症发生率的有效措施。方法2003年1月~2005年7月,我院接受ERCP诊断及治疗的患者916例,记录并分析其操作过程及术后并发症的发生。结果在916例患者中,总操作成功率为94.7%,共有128例患者接受十二指肠乳头肌预切开术。术后严重并发症发生率为5.4%(50例),其中包括胰腺炎33例,胆管炎10例,消化道出血4例和消化道穿孔3例。另外,有297例患者出现术后高淀粉酶血症(占32.4%)。结论对于胰胆道疾病患者,诊断性和治疗性ERCP是安全有效的诊治措施,其术后并发症主要有胰腺炎、胆管炎、消化道出血、消化道穿孔和高淀粉酶血症。十二指肠乳头肌预切开术有助于提高ERCP选择性插管的成功率。

The Clinical Analysis of 916 Endoscopic Retrograde Cholangiopancreatography

Objective To study the utility and safety of diagnostic and therapeutic endoscopic retrograde cholangiopancreatography(ERCP) in patients with cholangiopancreatic tract diseases,and to find the methods of elevating the achievement ratio and decreasing the incidence of complications.Methods 916 patients who underwent diagnostic ERCP and/or therapeutic ERCP during January 2003 and July 2005 were enrolled.The data of the diagnosic or treative procedures and the complications were gathered.Results The achievement ratio of diagnostic and/or therapeutic ERCP were 94.7% in 916 patients.Pre-cut papillotomies were performed in 128 patients.50 patients(5.4%) were suffered with post-procedural severe complications,including 33 pancreatitis,10 cholangitis,4 bleeding and 3 perforation.In addition,297 cases(32.4%) experienced hyperamylasemia after ERCP.Conclusions Diagnostic and therapeutic ERCP are both effective and safe procedures in patients with cholangiopancreatic tract diseases.Their main complications were pancreatitis,cholangitis,bleeding,perforation and hyperamylasemia.Pre-cut papillotomy was helpful to elevate the achievement ratio of the selective catherization in process of ERCP.