Kurisu S, Matsuda S, Oyabu H, Tachibana S, Hatta T, Kita Y, Oki K
Department of Surgery, Hyogo Prefectural Awaji Hospital, Sumoto, Japan.
Nihon Geka Gakkai Zasshi. 1992 Sep;93(9):1128-31.
One hundred and forty-four urgent treatments for acute obstructive suppurative cholangitis (AOSC), acute obstructive cholangitis (AOC), or/and acute pancreatitis caused by impacted bile duct stones were performed for eight years from 1984 to 1991. The breakdown of these treatments are as follows. [table: see text] It was not easy to diagnose every severe case of AOSC. As a result, however, endoscopy was very effective both in diagnosis and treatment. Concerning patients with thinner bile duct, endoscopic drainage was useful than percutaneous drainage. We prefer ENBD to EST followed by basket extraction of bile duct stones in an emergency state. ENBD is a rather easy technique even for beginners of ERCP, and is less invasive. The life-saving effect of ENBD is not inferior to that of EST.
1984年至1991年的八年期间，共对144例由胆管结石嵌顿引起的急性梗阻性化脓性胆管炎（AOSC）、急性梗阻性胆管炎（AOC）或/和急性胰腺炎进行了紧急治疗。这些治疗的分类如下。[表格：见正文] 诊断每一例严重的AOSC并不容易。然而，结果表明，内镜检查在诊断和治疗方面都非常有效。对于胆管较细的患者，内镜引流比经皮引流更有用。在紧急情况下，我们更倾向于内镜鼻胆管引流（ENBD）而非内镜下括约肌切开术（EST），随后用网篮取出胆管结石。ENBD即使对于ERCP初学者来说也是一种相当简单的技术，且侵入性较小。ENBD的挽救生命效果并不亚于EST。
