胆管梗阻性疾病ERCP的临床诊治分析

目的 :讨论ERCP对胆管梗阻性疾病的诊治价值。方法 :对患者ERCP诊断及治疗分析。结果 :ERCP成功率96 % ;胆管结石最常见 (占 70 83% ) ,其次胆道肿瘤 (占 2 0 31% ,其中胆管癌占 8 5 9%、壶腹癌及十二指肠乳头癌占7 81%、胰头癌占 3 90 % ) ,缩窄性乳头炎 (占 3 90 % )。 2 6 3例行EST及球囊扩张 ,其中取结石、蛔虫 2 5 2例 ,成功 2 4 2例 ,成功率 96 0 3% ;一次清除结石 2 17例 ,清除率 79 77% ;鼻胆引流管外引流 70例 ,支架内引流 6例 ;并发症发生率4 16 %。结论 :ERCP对梗阻性疾病有定位、定性诊断 ,诊断明确可靠。对胆道良性梗阻性疾病的治疗 ,成功率高 ,费用少 ,创伤小 ,并发症少 ,死亡率低 ,可代替部分外科手术 ;对胆道肿瘤 ,为外科创造手术条件或行姑息性引流治疗 ,提高患者生活质量 ,延长生命

Clinical Analysis of ERCP in Diagnosis and Treatment of Biliary Duct Obstructive Disease

Objective:To investigate the clinical value of ERCP in biliary duct obstructive disease. Methods: Results of diagnosis and treatment of ERCP were analyzed retrospectively. Results: The success rate in this study was 96%.The most frequent cause was cholelithiasis(70.83%). Cholangioma (20.31%)was the second frequent cause. Of them, cholaniosarcinoma was 8.59%, cancer of ampulla and duodenal papilla was 7.81%, constrictive papillitis 3.09%. 263 patients underwent EST or balloon dilation. Of them, 252 underwent bile stone or ascaris extraction, success rate was 96.03%(242/252). Bile stone was cleaned out at the first operation in 217 patients, the clearance was 79.77%. External drainage by nasal-bile duct were performed in 70 patients tube, and internal drainage using stent in 6 patients. The total incidence of complication was 4.61%. Conclusion: ERCP is dependable in qualitative and locating diagnosis of bile duct obstructive disease. With advantages, such as high success rate, low cost, minimal damage, less complications and low mortality, ERCP can partly replace surgical operations. Besides, ERCP can give chance to surgical operation by improving condition of patients with cholangiocarcinoma and improve patients' life quality and survival by palliative biliary drainage.