ERCP在胆囊切除术后胆总管结石诊断与治疗中的价值评价

The value evaluation of ERCP in diagnosis and treatment of common bile duct stones after cholecystectomy

目的:评价内镜下逆行胰胆管造影术(ERCP)对胆囊切除术后胆总管结石的诊断和治疗价值。方法:选择2005年1月～2007年12月期间在我院经ERCP检查者152例,将ERCP检查结果与B超、CT检查结果进行比较,对发现胆总管结石的患者行内镜下十二指肠乳头括约肌切开术(EST)取石。结果:83例胆囊切除术后胆总管结石患者,ERCP检测正确率显著高于B超、CT检测结果,差异有统计学意义(X2=53.05,X2=26.38,P<0.05)。内镜取石成功率为93.8(76/81),结石一次性清除率为81.6(62/76),并发症发生率为6.2(5/81);其中急性胆管炎1例,急性胰腺炎3例,消化道活动性出血1例。结论:ERCP是一种诊断和治疗胆囊切除术后胆总管结石的有效方法,其可作为胆囊切除术后胆总管结石的首选方法。

Objective：To evaluate the value of endoscopic retrograde cholangiopancreatography（ERCP）in diagnosis and treatment of common bile duct stones after cholecystectomy.Method：From January in 2005 to December in 2007,152 cases of ERCP were analyzed.The results of US,CT and ERCP were compared in diagnosing common bile duct stones.The patients diagnosed by ERCP with common bile duct stones were accepted endoscopic sphincterotomy（EST）.Results：In 83 cases with common bile duct stones after cholecystectomy,the correct rates of ERCP were significantly higher than that of US and CT（X2=53.05,X2=26.38,P0.05）.The successful rate of EST was 93.8%（76/81）and one time clearance rate was81.6%（62/76）.The incidence rate of complication was6.2%（5/81）,of which acute cholangitis occurred in 1 case,acute pancreatitis in 3cases and hemorrhage in 1 case.Conclusion：ERCP is the first method in diagnosis and treatment of common bile duct stones after cholecystectomy.