Chan Calvin H Y, Enns Robert A
University of British Columbia, St Paul's Hospital, Vancouver, Canada.
Curr Gastroenterol Rep. 2012 Dec;14(6):504-10. doi: 10.1007/s11894-012-0294-0.
The physiological changes of pregnancy increase the risk of gallstone formation, and choledocholithiaisis is the most common indication for endoscopic retrograde cholangiopancreatography (ERCP) during pregnancy. ERCP has been performed during pregnancy for over 20 years. Despite the apparent efficacy and lack of adverse fetal outcomes in published case series and reports, there remains a concern for the use of fluoroscopy during pregnancy. Recent focus has centered around avoidance of the use of fluoroscopy during ERCP, including the use of alternative techniques to confirm biliary cannulation and ductal clearance. The benefits of these techniques over traditional ERCP technique are unclear. In this article, we will review the epidemiology of gallstone disease during pregnancy, outline the risks of ERCP during pregnancy, and describe recent novel techniques in endoscopic biliary intervention for biliary drainage and ductal clearance.
妊娠期间的生理变化会增加胆结石形成的风险，而胆总管结石是孕期进行内镜逆行胰胆管造影（ERCP）最常见的指征。ERCP在孕期的应用已有20多年。尽管在已发表的病例系列和报告中显示出明显的疗效且未出现不良胎儿结局，但孕期使用荧光透视仍令人担忧。最近的关注点集中在避免在ERCP过程中使用荧光透视，包括使用替代技术来确认胆管插管和胆管清除情况。这些技术相对于传统ERCP技术的优势尚不清楚。在本文中，我们将回顾孕期胆结石疾病的流行病学，概述孕期ERCP的风险，并描述内镜胆道介入中用于胆汁引流和胆管清除的最新新技术。
