内镜下胆胰管逆行造影、T管会师术在十二指肠乳头括约肌功能紊乱诊治中的应用研究

Clinical application of EST through rendezvous technique of ERCP and T type tube in patients with SOD

目的探讨经内镜下胆胰管逆行造影(ERCP)、T管会师行乳头括约肌切开术(EST)治疗十二指肠乳头括约肌功能紊乱(SOD)及胆总管结石的临床效果。方法收集该院2005年5月～2009年5月经ERCP、T管会师行内镜下乳头括约肌切开术(EST)的SOD患者36例,并对患者的临床资料进行分析。结果 36例患者ERCP直接插管失败。34例患者经ERCP、T管会师顺利的完成EST,解除SOD,网篮成功取出胆管结石。术后恢复顺利,无胆道感染、急性胰腺炎等并发症的发生。T管胆道造影无残余结石及SOD。拔除T管治愈出院。另外2例患者因导丝不能经T管置入十二指肠,开腹手术治疗。结论 ERCP、T管会师成功地解决了SOD患者ERCP操作过程中插管困难的问题,避免了胆囊切除胆管探查术后再次手术,为SOD患者的实现微创治疗提供了一种途径,值得临床推广。

[Objective] To evaluate the clinical efficacy of EST through rendezvous technique of ERCP and T type tube in patients with SOD.[Methods] 36 patients with SOD,who underwent EST through rendezvous technique of ERCP and T type tube from May 2006 to May 2009 were retrospectively analyzed.[Results] All 36 cases were defeat in intubating into bile duct,34 cases were success in treating SOD and the bile ductal stone was removed after EST through rendezvous technique.All of patients recovered smoothly without any complications and discharged after removal of T type tube.The other 2 cases failed in doing rendezvous and performed operations.[Conclusions] ERCP by rendezvous technique of ERCP and T type tube provides a smooth way for the patients with SOD and avoid secondary operation.