内镜逆行性胰胆管造影术在肝胆管疾病中的诊断、治疗价值

The diagnostic and therapeutic value of ERCP in patients with hepatobiliary diseases

目的探讨治疗性内镜逆行性胰胆管造影术（ERCP）在胆胰疾病中的应用价值。方法回顾性分析行ERCP诊断、治疗的100例胆胰疾病患者的临床资料并与B超、CT诊断进行比较。结果100例患者行ERCP诊断、治疗，成功95例（95．0％）；行ERCP单纯诊断的64例，经内镜括约肌切开取石（EST）36例，其中胆总管单发结石14例，多发结石19例；ERCP、B超和CT诊断率分别为96．0％、39．O％和64．0％，ERCP诊断率高于B超和CT（Х^2=7．05，P〈0．01，Х^2=3．83，P〈0．05）；术后并发症胃肠道出血2例（2．0％）、急性胆管炎1例（1．0％）；急性胰腺炎2例（2．0）％，均经内科保守治疗全愈。结论ERCP对胆胰疾病是一种有效的诊断、治疗手段。

Objective To investigate the value of therapeutic endoscopic retrograde eholangiopancreatography（ERCP） in the patients with pancreaticobiliary diseases and the methods to manage complications. Methods 100 cases treated with ERCP were analyzed retrospectively. Compared with hepatobiliary diseases were examined with ER- CP, abdominal B-ultrasound and CT simultaneously. Results 100 eases underwent ERCP, the success and failure were 95 cases and 5 cases respectively;64 cases with simple diagnostic in ERCP,36 eases in EST;EST was performed on 36 patients with hepatobiliary stones. Stones were removed from 14 patients with single common bile duct stones and 19 patients with multiple duct stones;The diagnostic rate of ERCP, abdominal B ultrasound, CT were 96.0% 39. 0% and 64.0% respectively. The rate of diagnosis in ERCP were higher than the B ultrasound and CT （ Х^2 = 7.05, P 〈 0.01, Х^2 = 3.83, P 〈 0. 05 ） ; The complication of gastre-intestinal tract bleeds in 2 cases （ 2.0% ）, acute cholangitis in 1 case（ 1.0% ） ,acute pancreatitis in 2 cases（2.0）% ,pass through the internal medicine to treat conservatively completely recovers from an illness after treatment. Conclusion Therapeutic ERCP was effective and minimally invasive treatment for pancreaticobiliary diseases.