B超引导下急性化脓性胆管炎的内镜治疗

B ultrasound guided endoscopic therapy on acute suppurative cholangitis

目的探讨B超引导下急性化脓性胆管炎的内镜治疗效果和临床应用价值。方法对52例急性化脓性胆管炎的病人行急诊B超引导下内镜治疗,包括鼻胆管引流术、乳头括约肌切开及取(碎)石术、掏取肝吸虫和胆管狭窄扩张术。结果该组52例中,病情危重者直接放置鼻胆管20例;行内镜治疗后放置鼻胆管32例。术后1周内,所有患者的临床症状、肝功能等指标明显好转。引流后,择期手术治疗8例,部分病人择期再次行内镜治疗术。术后并发胰腺炎4例,保守治疗后痊愈。结论B超引导下内镜治疗急性化脓性胆管炎简便快捷,安全有效,值得临床推广应用。

[Objective] To explore the clinical effect and value of B ultrasound guided endoscopic therapy on acute suppurative cholangitis （ASC）. [Methods] A group of 52 emergent cases were involved in this study. All patients were diagnosed to be ASC and undergone endoscopic therapy including Endoscopic Nasal Biliary Drainage （ENBD）, Endoscopic Sphincterotomy （EST）, drawing out liver flukes, and dilatation of strictured Bile duct. [Results] In the above 52 cases, nasal bile drainage tube setting was performed directly for serious patients in 20 cases; nasal bile drainage tube setting was performed after endoscopic therapy in 32 cases. All patients＇ clinical symptom and liver function were improved obviously in a week. 8 cases underwent operation after plenty drainage, while some patients underwent endoscopic re-therapy. Pancreatitis related to endoscopy was found in 4 cases and cured with traditional therapy. [Conclusions] B ultrasound guided endoscopic therapy on acute suppurative cholangitis should be promoted in clinic for its convenience, safety, and efficiency.