Shi Yuyan, Zhong Jinghon, Zhou Jianbo, Song Qifeng
Department of Gastroenterology, Yuyao People's Hospital, Yuyao, Zhejiang, China.
Department of Anesthesiology, Yuyao People's Hospital, Yuyao, Zhejiang, China.
Evid Based Complement Alternat Med. 2022 May 2;2022:2662435. doi: 10.1155/2022/2662435. eCollection 2022.
The treatment of choledocholithiasis with duodenal stenosis is a clinical difficult problem. This study aimed to investigate the efficacy and safety of ERCP via gastroscopy in the treatment of choledocholithiasis and duodenal stenosis.
From January 2015 to December 2020, 21 patients with choledocholithiasis with duodenal stenosis who underwent ERCP treatment under gastroscopy in our hospital were enrolled. The patients' case characteristics, ERCP status, and complication rate were analyzed.
Among the 21 patients, 17 cases were successful in ERCP, and a total of 29 times ERCPs were performed, with an average of 1.71 times per patient. Among the failures of ERCP, selective deep intubation of common bile duct was unsuccessful in 4 cases. Six patients underwent multiple lithotomies, after the operation, of which 4 patients underwent secondary ERCP lithotomy and 2 patients underwent triple ERCP lithotomy. All patients successfully completed the balloon dilation without serious complications. Two patients developed mild acute pancreatitis after ERCP, and all recovered after medication.
In patients with choledocholithiasis and duodenal stenosis, ERCP treatment by gastroscopy has a higher success rate and does not increase the incidence of complications, but there is a problem of cholecystolithiasis recurrence.
胆总管结石合并十二指肠狭窄的治疗是临床难题。本研究旨在探讨经胃镜逆行胰胆管造影术（ERCP）治疗胆总管结石合并十二指肠狭窄的有效性和安全性。
选取2015年1月至2020年12月在我院接受经胃镜ERCP治疗的21例胆总管结石合并十二指肠狭窄患者。分析患者的病例特征、ERCP情况及并发症发生率。
21例患者中，17例ERCP成功，共进行29次ERCP，平均每人1.71次。ERCP失败的4例中，胆总管选择性深插管未成功。6例患者接受多次取石术，术后，其中4例患者接受二次ERCP取石术，2例患者接受三次ERCP取石术。所有患者均成功完成球囊扩张，无严重并发症。2例患者ERCP术后发生轻度急性胰腺炎，经药物治疗后均康复。
对于胆总管结石合并十二指肠狭窄患者，经胃镜ERCP治疗成功率较高，且不增加并发症发生率，但存在胆囊结石复发问题。
