CAJ | 학술논문

目的探讨消化道重建患者经腹壁空肠造瘘行ERCP诊疗的疗效及安全性.方法回顾性分析22例经腹壁空肠造瘘行ERCP诊疗的消化道重建患者的疗效及并发症发生情况.结果 22例均一次性完成经腹壁空肠造瘘,其中21例(95.5％)成功完成ERCP诊疗,内镜通过瘘口到达乳头或胆肠吻合口处的时间为6～34 min,平均为18.4 min;另外1例失败.ERCP诊断吻合口狭窄10例、肿瘤复发8例、胆总管结石1例、内支架堵塞1例,1例未见明显异常.置入塑料胆道内支架9例,置入金属胆道支架7例,更换塑料内支架1例,取石1例,仅行柱状球囊扩张2例.术后并发早期切口感染4例,并发胆道感染1例,并发肠瘘1例.结论对于消化道重建患者经腹壁空肠造瘘行ERCP是一种安全、有效、微创的治疗方法,可以在临床上推广使用.
목적 탐토소화도중건환자경복벽공장조루행ERCP진료적료효급안전성.방법 회고성분석22례경복벽공장조루행ERCP진료적소화도중건환자적료효급병발증발생정황.결과 22례균일차성완성경복벽공장조루,기중21례(95.5％)성공완성ERCP진료,내경통과루구도체유두혹담장문합구처적시간위6～34 min,평균위18.4 min;령외1례실패.ERCP진단문합구협착10례、종류복발8례、담총관결석1례、내지가도새1례,1례미견명현이상.치입소료담도내지가9례,치입금속담도지가7례,경환소료내지가1례,취석1례,부행주상구낭확장2례.술후병발조기절구감염4례,병발담도감염1례,병발장루1례.결론 대우소화도중건환자경복벽공장조루행ERCP시일충안전、유효、미창적치료방법,가이재림상상추엄사용.
Objective To investigate the effectiveness and safety of jejunostomy ERCP via the abdominal wall in patients with digestive tract reconstruction.Methods Data of 22 patients with digestive tract reconstruction,who underwent ERCP by jejunostomy,were retrospectively analyzed for effectiveness and complications.Results Jejunostomy through the abdominal wall was completed in all patients.ERCP was successfully completed in 21 patients,where the duodenal papilla or anastomotic stoma were reached,and the time was 6 to 34 minutes,mean 18.4 minutes.It failed in one case and the success rate was 95.5％.Under endoscopy,anastomotic stenosis was diagnosed in 10 cases,tumor recurrence in 8 cases,choledocholithiasis in 1 case,stent blockage in 1 case,no abnormality was seen in 1 case.Plastic stenting was performed in 9 patients,metal stenting in 7 patients,replacement plastic stent in 1 patient,stone removal in 1 patient,cylindrical balloon dilation in 2 patients.Post-ERCP complications included 4 cases of incisional infection,1 biliary tract infection and 1 intestinal fistula.Conclusion Jejunostomy ERCP through the abdominal wall in patients with digestive tract reconstruction is safe,effective and minimally invasive,which can be applied to clinical practice.