ERCP对胆胰疾病的诊断价值

目的探讨ERCP对胆胰疾病的诊断价值。方法对2007年07月-2008年07月胆胰疾病经B超、CT、MRCP检查诊断未明的行诊断性ERCP的患者进行分析研究。结果共行诊断性ERCP50例（其中单纯诊断23例，诊断＋治疗27例），其中失败2例，未见异常3例，各种恶性肿瘤15例，良性肿瘤2例，Oddi括约肌功能障碍（SOD）11例（其中乳头狭窄9例），原发性硬化性胆管炎（PSC）3例，胆管良性狭窄伴结石7例，胆、胰管变异5例，Mirrizi综合征1例，胆总管十二指肠瘘1例。术后并发轻型胰腺炎2例，高淀粉酶血症2例，术中局部渗血2例。结论B超、CT或MRCP无法完全代替ERCP，ERCP仍是诊断胆胰疾病的金标准，诊断性ERCP具有一定的并发症，因此要严格掌握适应证。

Diagnostic Value of ERCP in Patients with Biliary and Pancreatic Diseases

Objective To evaluate the diagnostic value of ERCP for biliary and pancreatic diseases.Methods Patients from 2007-07 to 2008-07 who received ERCP after ineffective B-ultrosound,computed tomography（CT） or magnetic resonance cholangiopancreatography （MRCP）.Results All 50 patients were performed ERCP（purely diagnostic ERCP 23 cases,diagnostic and therapeutic ERCP 27 cases）.2 cases failed,3 normal, 15 malignant tumors, 2 benign tumors, 11 SOD,3 primary sclerosing cholangitis（PSC）,7 benign biliary stricture with stones,5 biliary and pancreatic aberrance, 1 Mirrizi syndrome, 1 biliary duct-duodenom fistula.Post-ERCP pancreatitis occurred in 2 patients, hyperamylasemia 2 patients and mild bleeding 2 patients.Conclusion That B-ultrosound,CT or MRCP cannot completely take the place of ERCP.ERCP is the golden standard for diagnosing biliary and pancreatic diseases. Diagnostic ERCP is associated with risks and should be strictly controlled.