[逆行胰胆管造影术（ERCP）及内镜下十二指肠乳头括约肌切开术（ES）在胆总管结石诊断与治疗中的应用]

[Retrograde cholangiopancreatography (ERCP) and endoscopic sphincteropapillotomy (ES) in the diagnosis and treatment of common bile duct (CBD) lithiasis].

作者信息

Bălan G, al-Rahie A, Creţu M, Gologan E, Trifan A, Stanciu C

机构信息

Clinica Medicală II Gastroenterologie, Universitatea de Medicină şi Farmacie Gr. T. Popa, Iaşi.

出版信息

Rev Med Chir Soc Med Nat Iasi. 1995 Jan-Jun;99(1-2):56-62.

PMID:9524657

Abstract

The common bile duct (CBD) stones often gives real difficulties of diagnosis and treatment. The ultrasound (US) does not offer in a significant percentage of cases certain diagnostic data, and the unconventional imaging techniques such as computer tomography (CT) are yet less accessible. ERCP appeared in the last period as an optional method for the diagnosis of common bile duct stones, and, moreover, permitted the development of the nonsurgical treatment possibilities. ES and the extraction of stones revealed in this frame as preferable, especially in the high surgical risk cases. This study presents the results of ERCP performed in 547 and the therapeutic value of ES in 284 cases with CBD stones (conclusions of the ERCP and ES used in the clinical practice, in our clinic, in the last three years). In 81.69% cases ES managed the dezobstruction of the CBD, with a frequency of complications of 4.33% and a related mortality rate of 0.78%.

摘要

胆总管（CBD）结石常常给诊断和治疗带来实际困难。超声（US）在相当比例的病例中无法提供某些诊断数据，而计算机断层扫描（CT）等非常规成像技术则更难获得。内镜逆行胰胆管造影（ERCP）在最近一段时间成为诊断胆总管结石的一种可选方法，此外，还为非手术治疗提供了可能。在此背景下，内镜下括约肌切开术（ES）和结石取出术显示出更具优势，尤其是在手术风险较高的病例中。本研究展示了对547例患者进行ERCP的结果以及对284例胆总管结石患者进行ES的治疗价值（过去三年在我们诊所临床实践中使用ERCP和ES的结论）。在81.69%的病例中，ES成功解除了胆总管梗阻，并发症发生率为4.33%，相关死亡率为0.78%。