中华消化内镜杂志
中華消化內鏡雜誌
중화소화내경잡지
CHINESE JOURNAL OF DIGESTIVE ENDOSCOPY
2012年
10期
563-567
,共5页
潘亚敏%吴军%王田田%高道健%胡冰
潘亞敏%吳軍%王田田%高道健%鬍冰
반아민%오군%왕전전%고도건%호빙
胰胆管造影术,内窥镜逆行%十二指肠狭窄%方法
胰膽管造影術,內窺鏡逆行%十二指腸狹窄%方法
이담관조영술,내규경역행%십이지장협착%방법
Cholangiopancreatography,endoscopic retrograde%Duodenum stricture%Methods
目的 探讨合并十二指肠狭窄患者实施ERCP诊疗的方法与策略.方法 回顾性分析合并十二指肠狭窄患者的ERCP处理方法,观察内镜操作的成功率及并发症.结果 7276例接受ERCP的患者中,合并十二指肠狭窄158例(2.17％),其中恶性肿瘤浸润肠壁120例,十二指肠良性狭窄38例.采用改变体位或导丝引导的方法顺利通过狭窄处完成ERCP及胆道引流96例,实施柱状水囊扩张术后完成ERCP 33例,先放置十二指肠金属支架后行胆管引流4例,另有25例未能完成或放弃治疗.内镜操作成功率84.2％ (133/158),术中有少量出血5例,未发生持续出血或穿孔等并发症.结论 十二指肠狭窄患者仍有可能完成ERCP操作,轻度狭窄可通过改变体位或导丝引导帮助内镜通过,重度狭窄需采用水囊扩张或先留置肠道支架,根据局部病变情况循序应用以上方法实施内镜治疗仍是安全的,且成功率较高.
目的 探討閤併十二指腸狹窄患者實施ERCP診療的方法與策略.方法 迴顧性分析閤併十二指腸狹窄患者的ERCP處理方法,觀察內鏡操作的成功率及併髮癥.結果 7276例接受ERCP的患者中,閤併十二指腸狹窄158例(2.17％),其中噁性腫瘤浸潤腸壁120例,十二指腸良性狹窄38例.採用改變體位或導絲引導的方法順利通過狹窄處完成ERCP及膽道引流96例,實施柱狀水囊擴張術後完成ERCP 33例,先放置十二指腸金屬支架後行膽管引流4例,另有25例未能完成或放棄治療.內鏡操作成功率84.2％ (133/158),術中有少量齣血5例,未髮生持續齣血或穿孔等併髮癥.結論 十二指腸狹窄患者仍有可能完成ERCP操作,輕度狹窄可通過改變體位或導絲引導幫助內鏡通過,重度狹窄需採用水囊擴張或先留置腸道支架,根據跼部病變情況循序應用以上方法實施內鏡治療仍是安全的,且成功率較高.
목적 탐토합병십이지장협착환자실시ERCP진료적방법여책략.방법 회고성분석합병십이지장협착환자적ERCP처리방법,관찰내경조작적성공솔급병발증.결과 7276례접수ERCP적환자중,합병십이지장협착158례(2.17％),기중악성종류침윤장벽120례,십이지장량성협착38례.채용개변체위혹도사인도적방법순리통과협착처완성ERCP급담도인류96례,실시주상수낭확장술후완성ERCP 33례,선방치십이지장금속지가후행담관인류4례,령유25례미능완성혹방기치료.내경조작성공솔84.2％ (133/158),술중유소량출혈5례,미발생지속출혈혹천공등병발증.결론 십이지장협착환자잉유가능완성ERCP조작,경도협착가통과개변체위혹도사인도방조내경통과,중도협착수채용수낭확장혹선류치장도지가,근거국부병변정황순서응용이상방법실시내경치료잉시안전적,차성공솔교고.
Objective To investigate the methods and strategies of therapeutic ERCP in patients with duodenum stricture.Methods Endoscopic procedure,success rate and complications in patients with duodenum stricture who underwent ERCP were retrospectively analyzed.Results In 7276 patients who underwent therapeutic ERCP,duodenum stricture was found in 158 (2.17％),patients with malignant tumor infiltration in 120 and benign stricture in 38.The total success rate of ERCP and biliary drainage was 84.2％,with posture change or guidewire leading method in 96 patients,stylolitic water sac dilation in 33and duodenum metal stent placement before biliary drainage in 4.The procedure was failed in 25 patients.Minor bleeding occurred in 5 patients and no major complication including massive bleeding or perforation was observed.Conclusion ERCP is safe,effective and feasible for patients with duodenum stricture,which can be performed by posture change or guidewire leading method in mild stricture,and stylolitic water sac dilation or duodenum metal stent placement in severe stricture.
