ERCP在胆囊切除术后黄疸诊治中的应用

目的：探讨经内镜逆行胆胰管造影（endoscopicretrogradecholangiopancreatograp11y，ERCP）在胆囊切除术后黄疸患者的诊断和治疗中的应用价值。方法：对53例胆囊切除术后不明原因或考虑为外科原因的黄疸患者行ERCP检查，明确黄疸的原因并在内镜下采取相应的治疗措施。对于胆总管结石的患者行乳头括约肌切开（endoscopicsphincterotomy，EST）或乳头球囊扩张（endoscopicpapillaryballoondilation，EPBD）取石，对胆漏和胆道狭窄患者行内镜引流术，对乳头狭窄或括约肌功能异常的患者行EST或EPBD。结果：53例患者均成功行ERCP检查，结果显示胆总管结石38例、胆道损伤8例、乳头狭窄或括约肌功能异常3例、乳头癌1例、肝门胆管癌1例、未见异常2例。经相应治疗后，所有患者均未出现严重并发症。结论：对于胆囊切除术后出现黄疸的患者，ERCP是理想的诊断方法，同时还可以进行内镜下治疗。

Value of ERCP in the Diagnosis and Treatment of Post-Cholecystectomy Obstructive Jaundice

Objective：To investigate the value of endoscopic retrograde cholangiopancreatography（ERCP） in the diagnosis and treatment of post-cholecystectomy obstructive jaundice. Methods： A total of 53 patients who suffered from post cholecystectomy jaundice underwent ERCP. Patients with common bile duct （CBD） stones underwent endoscopic sphincterotomy （EST） or en- doscopic papillary balloon dilation（EPgD）. Those with bile leakage and biliary stricture underwent biliary drainage. Those with papillary stenosis and sphincter of Oddi dysfunction underwent EST or EPBD. Results： All the 53 cases underwent ERCP successfully. CBD stones were found in 38 cases; bile duct injuries were found in 8 cases; papillary stenosis and sphincter of Oddi dysfunction were found in 3 cases, carcinoma were found at papilla and hepatic portal in 2 cases; the other 2 cases displayed no abnormalities in ERCP. No severe complication occured in any cases. Conclusion： ERCP is of great value for the diagnosis and treatment of post-cholecystectomy obstructive jaundice,