镰状细胞胆管病：内镜逆行胰胆管造影评估。
Sickle cell cholangiopathy: an endoscopic retrograde cholangiopancreatography evaluation.
机构信息
Department of Internal Medicine, King Fahad Specialist Hospital, Dammam, Qatif, Saudi Arabia.
出版信息
World J Gastroenterol. 2009 Nov 14;15(42):5316-20. doi: 10.3748/wjg.15.5316.
AIM
To evaluate the role of endoscopic retrograde cholangiopancreatography (ERCP) in patients with sickle cell disease (SCD).
METHODS
Two hundred and twenty four SCD patients with cholestatic jaundice (CJ) had ERCP. The indications for ERCP were based on clinical and biochemical evidence of CJ and ultrasound findings.
RESULTS
Two hundred and forty ERCPs were performed. The indications for ERCP were: CJ only in 79, CJ and dilated bile ducts without stones in 103, and CJ and bile duct stones in 42. For those with CJ only, ERCP was normal in 42 (53.2%), and 13 (16.5%) had dilated bile ducts without an obstructive cause. In the remaining 22, there were bile duct stones with or without dilation. For those with CJ, dilated bile ducts and no stones, ERCP was normal in 17 (16.5%), and 28 (27.2%) had dilated bile ducts without an obstructive cause. In the remaining 58, there were bile ducts stones with or without dilation. For those with CJ and bile duct stones, ERCP was normal in two (4.8%), and 14 (33.3%) had dilated bile ducts without an obstructive cause. In the remaining 26, there were bile duct stones with or without dilatation.
CONCLUSION
Considering the high frequency of biliary sludge and bile duct stones in SCD, endoscopic sphincterotomy might prove helpful in these patients.
目的
评估内镜逆行胰胆管造影（ERCP）在镰状细胞病（SCD）患者中的作用。
方法
224 例伴有胆汁淤积性黄疸（CJ）的 SCD 患者接受了 ERCP。ERCP 的适应证基于 CJ 的临床和生化证据以及超声检查结果。
结果
共进行了 240 次 ERCP。ERCP 的适应证为：仅 CJ 79 例，CJ 和无结石扩张胆管 103 例，CJ 和胆管结石 42 例。对于仅 CJ 的患者，42 例（53.2%）ERCP 正常，13 例（16.5%）无梗阻原因的扩张胆管。其余 22 例中，存在胆管结石伴或不伴扩张。对于 CJ 和扩张胆管且无结石的患者，17 例（16.5%）ERCP 正常，28 例（27.2%）无梗阻原因的扩张胆管。其余 58 例中，存在胆管结石伴或不伴扩张。对于 CJ 和胆管结石的患者，2 例（4.8%）ERCP 正常，14 例（33.3%）无梗阻原因的扩张胆管。其余 26 例中，存在胆管结石伴或不伴扩张。
结论
鉴于 SCD 中胆泥和胆管结石的高频率，内镜括约肌切开术可能对这些患者有益。
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