内镜逆行胰胆管造影术诊疗胆胰疾病

目的评价内镜逆行胰胆管造影(ERCP)和内镜括约肌切开术(EST)在诊断及治疗胆胰疾病中的价值。方法对比分析ERCP及EST术与术前B超、CT及MRCP检查的准确性。结果61例中58例ERCP造影成功,造影成功率95.1%,2例取石失败,3例未取净,其中9例行CT,25例行MRCP检查。B超、CT和MRCP与ER-CP的总符合率分别为67.2%、77.8%和92%(23/25),其中MRCP对结石诊断符合率93.3%(14/15),对炎性狭窄诊断符合率100%(9/9)。ERCP检查术后并发症发生率为3.3%,MRCP术后无并发症发生。结论ERCP和EST诊断胆胰疾病准确率高,患者痛苦小,对胆总管结石的治疗安全有效;MRCP为无创检查,对胆管内疾病的诊断几可达到ERCP诊断水平,但不能进行治疗。

Objective To evaluate endoscopic retrograde cholangiopancreatography （ERCP） and endoscopic sphincterectomy （EST） in the diagnosis and treatment of bileduct and pancreatic tract diseases. Methods Compare the accuracy of ERCP and EST with US, CT and magnetic resonance cholangiopancreatography （MRCP） . Results Of all the 61 patients, 58 cases were successful, the successful rate was 95.1%. CT examination was performed in 9 cases and MRCP in 25. The coincidence rate of US, CT, MRCP to ERCP were 67.2%, 77.8% and 92% respectively. The complication rate of ERCP was 3.3%, and which of MRCP was zero. Conclusion ERCP and EST, which have a high sensitivity in the diagnosis of bile duct and pancreatic tract diseases, can treat patients of choledocholithiasis efficiently and safely. MRCP is a noninvasive tecnique and has nearly the same accuracy with ERCP in the diagnosis of bile duct and pancreatic tract diseases, but it cannot be used in treatment.