ERCP联合胆道微结石检测对明确特发性急性胰腺炎病因的价值

ERCP combined with detection of biliary microlithiasis in the diagnosis of idiopathic acute pancreatitis

目的:探讨内镜逆行胰胆管造影(endoscopic retrograde cholangiopancreatography,ERCP)联合胆道微结石检测对特发性急性胰腺炎(idiopathic pancreatitis,IAP)病因的诊断价值.方法:以2008-01/2011-01急性胰腺炎(acute pancreatitis,AP)患者105例为研究对象,选择影像学(CT、B超、MRCP)检查后不能明确病因的特发性急性胰腺炎患者42例进行诊断性ERCP检查,同时收集胆汁5mL行胆道微结石监测.以2005-01/2008-01AP患者90例为对照组,应用SPSS13.0统计软件统计,取P<0.05差异有统计学意义.结果:对照组对AP病因确诊率为55.5%(50/90),联合检查组对AP的病因确诊率为87.5%(93/105),差异有统计学意义(P<0.05),ERCP联合胆道微结石检测对IAP病因有较高的确诊率.结论:ERCP联合胆道微结石检测对明确IAP病因有重要价值.

AIM： To evaluate the diagnostic value of ERCP combined with detection of biliary microlithiasis for idiopathic acute pancreatitis （IAP）. METHODS： A total of 105 patients who were diagnosed with acute pancreatitis （AP） from Janu- ary 2008 to January 2011 were included in this study. Forty-two patients with lAP, in whom no cause can be found after conventional imaging examinations, received diagnostic ERCP. For each patient, five milliliter of bile was collected and examined under a polarized light microscope immediately to detect biliary microlithiasis. Ninty AP patients were used as controls. RESULTS： The diagnostic accuracy of conventional imaging examinations for the cause of AP was 55.5% （50/90）, while that of ERCP combined with biliary microlithiasis examination was 87.5% （93/105）, with a significant difference between the two groups （P 〈 0.05）. ERCP com- bined with detection of biliary microlithiasis had a higher accuracy in the diagnosis of IAP. CONCLUSION： ERCP combined with detection of biliary microlithiasis can improve the accuracy of diagnosis of IAP.