内镜处理复杂性胆道蛔虫症

Endoscopic treated with complicated biliary ascariasis

９５例复杂性胆道蛔虫症包括胆管内蛔虫断体（４１例）．胆总管内多条蛔虫（２１例）．胆管内死蛔虫并急性胆管炎（１２例）．胆道蛔虫并肝胆管结石（１１例）．胆道蛔虫并胆总管十二指肠乳头旁瘘（１０例）。全部病人应用内镜圈套器取虫．有的附加鼻胆管引流。９５例中８５例成功取出（或排出）蛔虫，１０例失败。总成功率８９．５％。本组无死亡。但３例取虫后并发胰腺炎．经支持疗法治愈。对复杂性胆道蛔虫症患者．内镜取虫是一种有发展前途的非手术方法。

Ninety-five patients of complicated binary ascariasis including the fragments within the bile duct (41 patients), multiple ascarides in the common bile duct (21 ),dead worm in the duct with acute cholangitis (12), binary ascariasis associated with hepatocholelithiasis (11 ), and ascaris simultaneous with juxtapapillary choledochoduodenal fistula (10 ), were managed by endoscopic snare worms retrieval with or without endoscopic nasobiliary catheter drainage(ENBD). In whom 85 cases had successful removal of the worms, the endoscopic sphincterotomy was not necessary, 10 Patients failed due to association with hepatocholelithiasis. The overall success rate was 89. 5%. There was no mortality in the series, but 3 patients with complication of pancreatitis after worm removal, they all recovered with conservative treatment. We consider endoscopic worms removal a viable alternative to surgery in patients with complicated binary ascariasis.