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[内镜逆行胰胆管造影术(ERCP)后穿孔]

[Perforations following endoscopic retrograde cholangiopancreatography (ERCP)].

作者信息

Mateo Retuerta J, Chaveli Díaz C, Goikoetxea Urdiain A, Sainz Villacampa B, Sara Ongay M J, Íñigo Noain J J

机构信息

.

出版信息

An Sist Sanit Navar. 2017 Apr 30;40(1):145-151. doi: 10.23938/ASSN0014.

Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) associated with sphincterotomy is a useful procedure that is widely used in cases of choledocholithiasis and bile duct obstruction. In spite of being a safe test, there is a risk of complications like pancreatitis, haemorrhaging or perforation. Post-ERCP duodenal perforation is a rare event but has serious consequences if it is not treated early. The lesion mechanism, the place and extension of the perforation, as well as the clinical picture and radiographic findings will guide patient management, which must be individualised and constantly reevaluated. Its mortality is closely related to diagnostic and therapeutic delay. In those cases where a conservative attitude is adopted, close vigilance will be maintained facing the possibility of a worsening of the clinical picture and a change in its management.

摘要

内镜逆行胰胆管造影术(ERCP)联合括约肌切开术是一种有用的手术,广泛应用于胆总管结石和胆管梗阻病例。尽管该检查是安全的,但仍存在胰腺炎、出血或穿孔等并发症风险。ERCP术后十二指肠穿孔是一种罕见事件,但如果不早期治疗会产生严重后果。穿孔的病变机制、部位和范围,以及临床表现和影像学检查结果将指导患者的管理,管理必须个体化并持续重新评估。其死亡率与诊断和治疗延迟密切相关。在采取保守态度的情况下,面对临床表现恶化及其管理方式改变的可能性,将保持密切警惕。

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