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[内镜逆行胰胆管造影术在儿童胰胆疾病中的作用分析]

[Analysis of the role of endoscopic retrograde cholangiopancreatography in children with pancreaticobiliary diseases].

作者信息

Liu Wei, Wang Qiming, Zeng Hongze, Mou Yi, Yi Hang, Wu Chuncheng, Hu Bing, Tang Chengwei

机构信息

Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu.

Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu. Email:

出版信息

Zhonghua Er Ke Za Zhi. 2014 May;52(5):328-32.

PMID:24969928
Abstract

OBJECTIVE

To evaluate the safety and efficacy of endoscopic retrograde cholangiopancreatography (ERCP) in children with pancreaticobiliary diseases and the characteristics of pancreaticobiliary disorders in children.

METHOD

Retrospective review was conducted on the data of patients younger than 18 years who underwent ERCP between 2005 and 2012 at West China Hospital. The indications,ERCP findings, ERCP procedures, complications, and clinical outcomes were evaluated.ERCP procedures were performed using standard duodenoscopes under general anaesthesia or sedation, which included all endoscopic treatments, such as endoscopic sphincteropapillotomy, stone extraction, stent treatment and so on.

RESULT

One hundred and two ERCPs were performed on 68 patients, and all the procedures were successfully completed in 100% cases. There were 39 girls (57%), and median age at time of procedure was 14.6 years (range, 5-17 years).General anesthesia and sedation were performed in 81% and 19% of procedures, respectively. The ERCP findings were classified as follows:bile duct stone(s) (n = 37, 54%), pancreatic duct stone(s) (n = 8, 12%), bile duct benign stricture (n = 7, 10%) and other nonmalignant pancreaticobiliary diseases (n = 16, 24%).Four cases (4/102, prevalence 4%) were complicated with post-ERCP pancreatitis.Symptoms such as abdominal pain and jaundice were cured obviously after the procedures of ERCP were performed.

CONCLUSION

The main characteristics of pancreaticobiliary disorders in children were nonmalignant pancreaticobiliary diseases, such as bile duct stone, pancreatic duct stone, and bile/pancreatic duct benign stricture.When performed by well-trained endoscopists, ERCP is safe and effective in children.

摘要

目的

评估内镜逆行胰胆管造影术(ERCP)在儿童胰胆疾病中的安全性和有效性,以及儿童胰胆疾病的特点。

方法

回顾性分析2005年至2012年期间在华西医院接受ERCP的18岁以下患者的数据。评估其适应证、ERCP检查结果、ERCP操作过程、并发症及临床结局。ERCP操作在全身麻醉或镇静下使用标准十二指肠镜进行,包括所有内镜治疗,如内镜乳头括约肌切开术、取石术、支架置入术等。

结果

对68例患者进行了102次ERCP,所有操作均100%成功完成。其中女孩39例(57%),操作时的中位年龄为14.6岁(范围5 - 17岁)。分别有81%和19%的操作采用全身麻醉和镇静。ERCP检查结果分类如下:胆管结石(n = 37,54%)、胰管结石(n = 8,12%)、胆管良性狭窄(n = 7,10%)和其他非恶性胰胆疾病(n = 16,24%)。4例(4/102,发生率4%)发生ERCP术后胰腺炎。ERCP操作后,腹痛和黄疸等症状明显缓解。

结论

儿童胰胆疾病的主要特点是非恶性胰胆疾病,如胆管结石、胰管结石、胆管/胰管良性狭窄。由训练有素的内镜医师进行操作时,ERCP在儿童中是安全有效的。

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