胆总管结石继发急性梗阻性化脓性胆管炎的急诊内镜治疗

目的：探讨胆总管发急性梗阻性化脓性胆管炎的急诊内镜镜治疗方法，方法：118例胆总管结石继发急性梗阻性化脓性胆管炎患者接受ERCP检查和治疗，112例,人镜括约肌切开（EST）或内镜乳头气囊扩张（EPBD）取石梳 及放置鼻胆管引流（ENBD），结果：31例经EPBD后取石，39例经EST后取石，或同时放置ENBD，42例单纯放ENBD，105例患者经急诊治疗后症状得到缓解，无严重并发症和死亡，结论：内镜治疗急性胆管炎较传统开腹手术具有操作简单，安全，有效，创伤小和恢复快等优点。

Emergent Therapeutic ERCP in Patients with Acute Obstructive Suppurative Cholangitis Due to Common Bile Duct Stones

Objective:To study the efficacy of emergent endoscopic management for acute obstructive suppurative cholangitis(AOSC) due to common bile duct (CBD) stones.Methods:118 patients with AOSC caused by CBD stones underwent diagnostic ERCP,and emergent therpeutic ERCP succeeded in 112 patients (94.9%).The therapeutic ERCP included stones removal after endoscopic sphincterotomy (EST) or endoscopic papillary balloon dilation(EPBD) and subsequent endoscopic nasal biliary drainage(ENBD) or ENBD only.Results:Stones removal or subsequent ENBD was performed in 31 patients with EPBD and 39 with EST.42 patients received emergent ENBD only.Symptoms of 105 patients were relieved after the management described above without severe complictions or death.Conclusions:Compared with surgery,emergent therapeutic ERCP is a safe,simple and effective measure for acute cholangitis due to CBD stones.It offers an important alternative to surgery in the treatment of acuted cholangitis.