胆总管结石58例治疗中应用逆行胰胆管造影效果观察

Observation on 58 cases of common duct stones by endoscopic retrograde cholangiopancreatography

目的探讨逆行胰胆管造影(endoscopic retrograde cholangiopancreatography,ERCP)在胆总管结石病中的治疗方法及其效果。方法确诊为胆总管结石的58例患者根据结石的部位、大小、数目应用ERCP进行治疗。结果顺利插管并取石41例,碎石后取石7例,插管困难而选择针状刀预切开后顺利插管并取石9例,失败1例。手术后出现一过性淀粉酶升高7例,引起胰腺炎2例。结论 ERCP是胆总管结石诊治最有效、最有前景的技术,可为胆总管结石患者免于外科开腹手术,减少手术并发症,缩短住院时间,减轻患者痛苦。在插管困难的情况下选择针状刀预切开后均能成功插管,从而缩短手术时间,避免反复插管,提高成功率,降低术后胰腺炎的发生率。

Objective To examine the efficiency and consequence of endoscopic retrograde cholangiopancreatography（ERCP）.Methods An overview of 58 individual cases were treated by ERCP according to the location,size and numbers of stones.Results Forty-one cases were successfully intubated and lithotomized.Seven cases underwent lithoplaxy.Nine cases were intubated after acupotomy due to the difficulty of intubation.One case failed.Seven cases manifested the increase of amylase after the operation,and 2 of them evoked pancreatitis.Conclusions ERCP shows its high efficiency and potential,which is free of laparotomy,has less complications,shorter hospital stay and the relieved pain.Difficult intubation can be achieved after acupotomy,which can shorten the duration of operation,guarantee the high successful rate and reduce the infection rate of pancreatitis.