ERCP在治疗腹腔镜胆囊切除术后胆管并发症中的应用

The application for ERCP in therapy of post-laparoscopic cholecystectomy biliary complications

目的探讨ERCP在治疗腹腔镜胆囊切除术后胆管并发症中的应用价值。方法回顾性分析近6年（2002年1月-2008年4月）间腹腔镜胆囊切除术后胆总管残余结石行乳头括约肌切开及气囊扩张术取石34例，LC术后胆漏行鼻胆管引流（ENBD）13例，胆管狭窄行胆管球囊扩张，放置胆管内支架4例。结果34例胆总管残余结石患者经乳头括约肌切开及气囊扩张术取石，其中有2例经2次操作取净结石。13例胆漏患者经鼻胆管引流6-11d后，胆漏均闭合，无严重并发症发生。4例胆管狭窄患者经胆管球囊扩张、放置胆管内支架治愈。结论ERCP在治疗腹腔镜胆囊切除术后胆管并发症中具有重要应用价值，是腹腔镜胆囊切除术后胆总管残余结石、胆漏及胆管狭窄的有效介入方法。

Objective To explore the values of ERCP in therapy of post-laparoscopic cholecystectomy biliary complications. Methods Totally 51 cases treated with ERCP were analyzed retrospectively, including 34 patients with cboledocholith residual after laparoscopic cholecystectomy（LC） given the EST or EPBD take out eholedooholith, 13 patients with biliary fistulas after LC given the endoscopic nasobiliary drainage（ENBD） and 4 patients with biliary tract stricture after LC treated by bile Balloon dilatatio,endoscopie stenting in biliary duets. Results 34 patients with eholedocholith residual after LC given the EST or EPBD take out choledocholith, including two eases of the two operations to take out choledocholith. There was no serious compli-cations in 13 patients with biliary fistulas and the biliary fistulas healed completely by ENBD after 6-11d. The 4 patients with stricture of bile ducts were cured by bile Balloon dilatatio, endoscopic stenting in biliary. Conclusion ERCP is one of the important method therapy of post-laparoscopic cholecystectomy biliary complications.