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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1997～2002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 59例，行两种检查者9例。总急性胆道并发症10例(9．09％)，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。直接胆道造影和胆道引流应是胰源性黄疸术前安全有效的诊断和治疗方法。

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

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.