内镜下乳头肌切开术后严重并发症诊断和外科治疗

目的 探讨和分析内镜下乳头肌切开术（EST）后严重并发症及其处理方法。方法 收治36例SET术后并发严重出血、穿孔、重症胰腺炎患者。其中单纯出血16例，单纯穿孔11例，穿孔伴出血6例，穿孔伴重症胰腺炎3例。结果 单纯出血14例，单纯穿孔11例，穿孔伴出血3例，穿孔伴重症胰腺炎1例患者均成活。单纯出血2例，穿孔伴出血3例，伴重症胰腺炎2例死亡。结论 SET并发症以出血最为常见。绝大多数并发症可经内科保守治疗而得以痊愈，一旦出现严重并发症，积极手术是降低死亡率的关键。

Diagnosis and Treatment of the Severe Complications After Endoscopic Sphincterotomy

Objective To investigate and analyze the severe complications and their surgical managements after endoscopic sphincterotomy(EST).Method 36 patients with complications after EST such as severe hemorrhage, perforation and severe pancreatitis were analyzed,of them there were 16 cases of hemorrhage, 11 case of perforation, 6 cases of hemorrhage combined with perforation and 3 cases of severe pancreatitis combined with perforation. Results 14 cases of merely hemorrhage patients, 11 cases of merely perforation patients, 1 case of perforation combined with severe pancreatitis patient and 3 case of perforation combined with hemorrhage patient were survived while 2 case of merely hemorrhage patient, 3 cases of perforation combined with hemorrhage patients and 2 case of perforation combined with severe pancreatitis patients died.Conclusions Hemorrhage is the most common complication of EST and most complications can be healed well through expectant treatment. Once severe complications occurred, prompt operations are the keys to lower the mortality.