急性梗阻性化脓性胆管炎的内镜治疗体会(附48例报告)

目的：探讨内镜治疗急性梗阻性化脓性胆管炎(AOSC)的应用价值。方法：对48例结石性急性梗阻化脓性胆管炎进行急诊内镜治疗，包括逆行胰胆管造影(ERCP)，鼻胆管引流(ENBD)，乳头括约肌切开(EST)及取石术。结果：AOSC内镜引流治疗有效率100％，取石成功率为85．4％(41／48)，余7例经内镜引流后择期手术。与内镜操作有关的并发症2例(4．17％)，均经保守治疗后痊愈。结论：急性梗阻性化脓性胆管炎应首选急诊内镜胆道引流或、和加上乳头括约肌切开术(EST)，其是一种安全、有效的现代微创技术。

Endoscopic treatment of acute obstructive suppurative cholangitis

Objective:To evaluate the clinical value of endoscopic therapy for acute obstructive supprative cholangitis(AOSC).Methods:48 cases with AOSC caused by bile duct stones underwent endoscopic therapy.The therapeutic endoscopic retrograde cholangiopancreatography(ERCP) included ERCP, endoscopic sphincterotomy.(EST),endoscopic nasobiliary drainage (ENBD)and extracted bile duct stones .Results: The effective rates of endoscopic management were 100%.Bile duct stones were moved out in 41 cases(85.4%),while the rest 7 cases underwent operation after the plenty drainage.Complication related to endoscopy were found in 2 cases (4.17%),Who were cured by the conservation therapy.Conclusions:As a safe , effective, modern therapy with minimal injury, endoscopic bile drainage or/and endoscopic sphincterotomy should be the first choice in case of acute obstructive supprative cholangitis.