CAJ | 학술논문

目的总结BillrothⅡ式胃切除术后患者进行ERCP诊治的经验,对其手术操作的成功率、安全性和有效性进行评估.方法回顾性分析2007年1月至2009年11月间,75例BillrothⅡ式术后因胆道疾患接受ERCP诊治患者的临床资料.结果 75例患者中,顺利进入空肠输入襻69例(92%),其中选择性胆道插管成功68例,3例行诊断性胆道造影检查,65例为治疗性操作.后者中16例行EST+取石+鼻胆管引流术,19例行塑料支架胆管引流术,18例金属支架胆管引流术,12例内镜下球囊扩张术+取石+鼻胆管引流术.1例患者因空肠输入襻穿孔(1.3%)急诊行手术治疗,2例(2.6%)并发术后急性胰腺炎,经保守治疗痊愈,无出血相关并发症.结论对于BillrothⅡ式术后患有胆道疾病的患者,进行ERCP诊治是安全、可行的.
목적 총결BillrothⅡ식위절제술후환자진행ERCP진치적경험,대기수술조작적성공솔、안전성화유효성진행평고.방법 회고성분석2007년1월지2009년11월간,75례BillrothⅡ식술후인담도질환접수ERCP진치환자적림상자료.결과 75례환자중,순리진입공장수입반69례(92%),기중선택성담도삽관성공68례,3례행진단성담도조영검사,65례위치료성조작.후자중16례행EST+취석+비담관인류술,19례행소료지가담관인류술,18례금속지가담관인류술,12례내경하구낭확장술+취석+비담관인류술.1례환자인공장수입반천공(1.3%)급진행수술치료,2례(2.6%)병발술후급성이선염,경보수치료전유,무출혈상관병발증.결론 대우BillrothⅡ식술후환유담도질병적환자,진행ERCP진치시안전、가행적.
Objective To evaluate the success rate, safety and efficacy of endoscopic retrograde cholangiopancreatography (ERCP) after Billroth Ⅱ gastrectomy. Methods Data of 75 patients with biliary disease after Billroth Ⅱ gastrectomy, who underwent ERCP from January 2007 to November 2009, were retrospectively analyzed. Results In 75 patients, afferent loop intubation was achieved in 69 (92%) and selective cannulation of bile duct were successful in 68 (68/69, 98. 5%). Diagnostic procedures were carried out in 3 patients, and therapeutic in 65 others, which included EST plus stone removal and ENBD in 16, ERBD in 19, EMBE in 18 and EBD plus stone removal and ENBD in 12. Afferent loop perforation occurred in 1 patient (1.3%) and was treated surgically, and 2 acute pancreatitis (2. 6%) were treated conservatively.There was no complication of bleeding. Conclusion ERCP after Billroth Ⅱ gastrectomy is safe and efficiency for biliary disease.