存有严重并发症的急性化脓性胆管炎的急诊内镜治疗

目的：探讨有严重并发症的急性化脓性胆管炎急诊内镜治疗的价值。方法：对18例有严重并发闰的急性化脓性胆管炎进行急诊内镜治疗，治疗方法包括逆行胰胆管造影（endoscopic retro-grade cholangiopancreatography，ERCP）、鼻胆管引流（endoscopic nasobiliary drainage，ENBD）和（或）乳头括约肌切开术（endoscopic sphincterotomy，EST）有取石术、胆道内支架置入术。结果：18例患者经急诊内镜治疗，完成治疗17例，成功率94.4%。取石成功14例（82.4%），单纯鼻胆管引流2例，胆总管塑料支架置入2例。产生与内镜有关的并发症1例（5.9%），无死亡病例，治愈率为88%。结论：急诊内镜治疗存有严重并发症的急性化脓性胆管炎创伤小、治愈率高、并发症少，是治疗存有严重并发症的急性化脓性胆管炎的一种好方法。

Treatment Experience of Acute Suppurative Cholangitis in Patients with Severe Medical Condition under Endoscopy

Objective To explore the effectiveness of endoscopic treatment in acute suppurative cholangitis with severe medical conditions. Methods Endoscopic therapy was given to 18 patients associated severe medical conditions diagnosed acute cholangitis. The therapy included ERCP,ENBD,EST and biliary endoprosthesis. Results 17 cases completed therapy (94.4%), bile duct stones were moved in 14 cases (82.4%), 2 patients received ENBD only, 2 patients underwent biliary endoprosthesis.The curative rate of cholangitis was 88%. Conclusions Endoscopic biliary tract drainage or combined with EST is the first choice to acute cholangitis associated severe medical conditions. It is a safe, quick and effective therapy.