内镜逆行胰胆管造影术在腹腔镜胆囊切除术围手术期的应用价值

目的探讨内镜逆行胰胆管造影术（endoscopic retrograde cholangiopancreatomography,ERCP）在腹腔镜胆囊切除术（laparoscopic cholecystectomy,LC）围手术期的应用价值。方法回顾分析2000年11月至2005年12月间96例LC围手术期经ERCP诊治的病例资料,评价其在LC围手术期的作用。结果术前ERCP 73例,成功71例,成功率为97.3%。71例中造影发现结石46例,炎性狭窄4例,乳头旁憩室3例,正常的18例;行EST＋ENBD 48例,取石成功44例。术中ERCP 16例,成功15例,成功率为93.7%;行EST 9例,取石7例,ENBD 9例。术后ERCP 7例,行EST＋ENBD 7例,取石3例。本组1例并发胰腺炎,保守治疗2周后治愈。结论LC围手术期行ERCP诊断和治疗安全有效。

Applied value of ERCP in the perioperative period of LC

Objective To discuss the applied value of ERCP in perioperative period of LC.MethodsNinety-six LC cases undergone ERCP in the perioperative period from Nov.2000 to Dec.2005 were retrospectively analyzed and the effects were evaluated.ResultsPreoperative ERCP were successfully carried out in 71 of 73 cases,with a successful rate of 97.3%.Of the 71 cases,46 choledocholithiasis,4 inflammatory stenosis,3 parapapillary diverticula and also 18 normal cases were detected by means of cholangiography;EST and ENBD were carried out in 48 cases,with 44 cases of successful lithotomy.Intraoperative ERCP were successfully carried out in 15 of 16 cases,with a successful rate of 93.7%.Of the 15 cases,9 cases were undergone EST,7 lithotomy,and another 9 ENBD.Postoperative ERCP were carried out in 7 cases.All of them were undergone EST+ENBD,and 3 of whom were undergone lithotomy.Only 1 case complicated with pancreatitis,who recovered after 2 weeks of conservative treatment.ConclusionThe application of ERCP in the perioperative period of LC is considered to be non-replaceable in clinical works due to its minimally invasiveness,safety and effectiveness in both diagnosis and treatment.