89例多次ERCP的原因探讨

Causes inducing ERCP for many times in 89 patients

目的对多次内镜下逆行胰胆管造影(ERCP)的必要性作一探讨.方法 5年来在该院所做4200次ERCP诊治的病人中,89例(2.1%)做了2次以上,其中最多的2例各为6次.本组男48例,女41例;平均年龄59岁(范围16～92岁).5例为诊断性ERCP,74例治疗性ERCP和10例属ERCP术后并发症.根据ERCP的情况所有病人均作了EST,并分别进行取石、内镜下内支架胆道引流术(ERBD)和内镜下鼻胆管引流术(ENBD).结果 5例诊断性ERCP的病人,于第2次造影很快获得成功.74例治疗性ERCP,包括6例十二指肠乳头良性狭窄、21例EST后和10例胆道术后结石残留或再发、16例ASP和AOSC、10例胆胰肿瘤、11例良性胆胰管狭窄放置内支架和10例ERCP后并发症.最终经多次治疗性ERCP均获成功.结论针对不同的病情,合理选择分次ERCP,可提高ERCP的安全性和成功率.

To study the causes and the necessity of ERCP performed for many times. ERCP was performed in 4200 patients in recent 5 years. 89 cases were performed for 6 times. In all patients, 5 cases performed for diagnosis, 74 cases for treatment and 10 cases for treatment to complication of ERCP. All cases were performed ERCP and EST, somoe caese with ERBD, ENBD accordingly. 5 cases for diagnosis were performed successfully in the second time of ERCP. 74 cases for treatment, including 6 cases with papilla benign constriction, 21 cases with gallstone recurrence or remained after ERCP and surgical operation, 16 cases with SAP or AOSC, 10 cases with biliary and pancreas tumor, 11 cases with biliary or pancreatic duct constriction and internal stents replacement and 10 cases with complications of ERCP were performed successfully in many times of ERCP at last. [Conclusions] According to different severity of patients, the security and success rate of ERCP selected and performed in different time may be improved.