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内镜超声检查在治疗远端炎性胆管狭窄中的作用:165例回顾性分析

The effect of endoscopic ultrasonography in treatment of distal inflammatory biliary stricture: a retrospective analysis of 165 cases.

作者信息

Hao Fang, Zheng Mingwei, Qin Mingfang

出版信息

Hepatogastroenterology. 2014 Nov-Dec;61(136):2177-80.

Abstract

BACKGROUND/AIMS: Endoscopic ultrasonography (EUS) are relatively new alternatives to surgery for the treatment of benign lesions in the biliary duct. This study was to explore the value of EUS in the treatment of distal inflammatory biliary stricture.

METHODOLOGY

165 patients with distal inflammatory biliary stricture underwent EUS, according to EUS, endoscopic retrograde cholangiopancreatography (ERCP), intraductal ultrasonography (IDUS), endoscopic retrograde biliary drainage and endoscopic biliary dilation were performed. The clinical data about therapies and recovery of 22 patients was recorded and analyzed.

RESULTS

In 165 patients, 163 cases underwent ERCP and intraductal ultrasonography (IDUS) successfully following EUS. Total 356 ERCPs were performed with 87 biliary duct stents inserted. After EUS the liver function, the thickness and pressure of biliary duct were decreased compared to these before EUS. The complication rate was 5.1% (18/356). After a follow-up of 27.6±10.6 months, strictures had not recurred in 121 patients after stents removed.

CONCLUSION

EUS for distal inflammatory biliary stricture can be selected as a safe, effective and minimally invasive therapeutic method.

摘要

背景/目的:内镜超声检查(EUS)是治疗胆管良性病变的一种相对较新的手术替代方法。本研究旨在探讨EUS在治疗远端炎性胆管狭窄中的价值。

方法

165例远端炎性胆管狭窄患者接受了EUS检查,根据EUS结果,进行了内镜逆行胰胆管造影(ERCP)、胆管内超声检查(IDUS)、内镜逆行胆管引流及内镜胆管扩张术。记录并分析了22例患者的治疗及恢复情况的临床资料。

结果

165例患者中,163例在EUS检查后成功接受了ERCP和IDUS检查。共进行了356次ERCP检查,置入了87个胆管支架。与EUS检查前相比,EUS检查后肝功能、胆管厚度及压力均有所下降。并发症发生率为5.1%(18/356)。经过27.6±10.6个月的随访,121例患者在取出支架后狭窄未复发。

结论

EUS可作为治疗远端炎性胆管狭窄的一种安全、有效且微创的治疗方法。

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