ERCP在胆管结石诊断和治疗中的应用

目的评价内镜下逆行胰胆管造影(ERCP)对胆管系统结石诊断和治疗的价值。方法对106例ERCP资料作回顾性分析,并将超声(US)、计算机断层扫描(CT)与ERCP的资料进行比较。结果胆囊结石的诊断US优于CT和EPCP,胆总管结石的诊断ERCP优于CT、US。本组病例中ERCP检查的胆管结石患者在明确诊断的同时通过内镜下乳头切开取石和/或鼻胆管引流解除梗阻。其中结石最小直径0.1cm,最大直径5cm,单发19例,多发37例。胆系结石主要位于胆总管和胆囊内,ERCP主要表现为胆总管内的充盈缺损,胆管扩张,下端梗阻时,可出现杯口状的充盈缺损,其上方胆管口径扩张。结论ERCP作为一种微创的诊断兼治疗的手段,对胆管结石有重要的临床应用价值。

The diagnosis and treatment of calculus in bile duct by ERCP

Objective To evaluate the value of ERCP in diagnosing and treatment of calculus of bile duct. Methods 106 cases of ERCP were analyzed retrospectively.The US,CT and ERCP were compared in diagnosing calculus of bile duct. Results The ability of US in diagnosing cholecystolithiasis was super to CT and ERCP. The ability of ERCP in diagnosing calculus of bile duct was super to CT and US. The calculus of bile duct were diagnosed and the obstruction were relieved by endoscopic papillotomy and/or nasobiliary catheter. The size of stone were 0.1cm~5cm. 19 cases had single and 37cases had multi-stones. The stones were in common bile duct and cholecyst. The filling defects and cholangiectasis were shown. Conclusions ERCP is a method of diagnosis and treatment of stones. It has important clinical value for calculus of bile duct.