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[儿童胰腺疾病的内镜逆行胰胆管造影临床应用分析]

[Analysis of clinical application of endoscopic retrograde cholangiopancreatography for the pancreatic diseases in children].

作者信息

Lü Tao, Zhang Xiao-Feng

机构信息

Department of Digestive Diseases, the First Hospital of Hangzhou, Hangzhou 310006, China.

出版信息

Zhonghua Er Ke Za Zhi. 2013 May;51(5):367-70.

Abstract

OBJECTIVE

To study the feasibility and risk of endoscopic retrograde cholangiopancreatography (ERCP) for children in clinic, and to evaluate the effects of ERCP in diagnosis and treatment of the pancreatic diseases in children.

METHOD

Totally 98 patients under 14 years of age who underwent ERCP from 1994 to 2011 were enrolled in the study. The data of diagnosis, anesthesia type, treatments, and postoperative complications were collected.

RESULT

The 98 patients were 4 to 14 years old, of whom 32 cases suffered from acute pancreatitis (30 cases with biliary disease and 2 with hyperlipidemia); 42 cases had chronic pancreatitis, of whom 36 had calculus of pancreatic duct, pancreatic pseudocyst was seen in 6 cases. Pancreas divisum was found in 20 cases, choledochopancreatic junction anomaly in 6 cases,and annular pancreas in 1 case. The operations of dissection of pancreatic duct and biliary duct, calculus removal, insertion of endoprosthesis and draining tube in pancreatic duct or biliary duct were performed. No patients died from ERCP complications. In observation of postoperative complications, acute pancreatitis after ERCP occurred in 1 case, with the incidence rate of 1%, 1 case had bleeding (1%), and 5 cases had hyperamylasemia (5%). All the complications were cured within 1 week. The average hospital stay was 5.51 d.

CONCLUSION

ERCP is useful and safe in children under suitable condition of doctors and equipments, and no high rates of complications were observed.

摘要

目的

探讨儿童内镜逆行胰胆管造影术(ERCP)临床应用的可行性及风险,评估ERCP对儿童胰腺疾病的诊治效果。

方法

选取1994年至2011年间接受ERCP的14岁以下患儿98例,收集其诊断、麻醉方式、治疗方法及术后并发症等资料。

结果

98例患儿年龄4至14岁,其中急性胰腺炎32例(胆源性30例,高脂血症性2例);慢性胰腺炎42例,其中胰管结石36例,胰腺假性囊肿6例。胰腺分裂症20例,胆胰管汇合异常6例,环状胰腺1例。均行胰胆管切开、取石、内置支架及胰胆管引流管置入等操作。无患儿因ERCP并发症死亡。术后并发症观察:ERCP术后急性胰腺炎1例,发生率1%;出血1例(1%);高淀粉酶血症5例(5%)。所有并发症均在1周内治愈。平均住院天数5.51 d。

结论

在具备合适的医生及设备条件下,ERCP应用于儿童是安全有效的,未观察到高并发症发生率。

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