内镜下逆行胰胆管造影技术诊治成人胆道蛔虫病19例的临床分析

Nineteen cases of biliary ascariasis diagnosed and managed by endoscopic retrograde cholangiopan- creatography

目的探讨内镜下逆行胰胆管造影（ERCP）在成人胆道蛔虫病诊断、治疗中的临床应用。方法回顾性分析沈阳军区总医院内镜科2005年1月至2012年12月收治的19例经ERCP诊断、治疗的成人胆道蛔虫病患者的临床资料。结果胆道蛔虫病患者共19例。其中男11例，女8例；平均年龄（62．7±10．8）岁。居住于农村8例，城乡结合部7例，城镇4例；全部病例均有生食蔬菜、瓜果习惯。19例患者中发现活体蛔虫9例，同时存在胆总管结石4例。胆总管内已死亡蛔虫残体石化10例，同时存在胆总管较大结石5例。全部患者均经内镜成功取出蛔虫和胆总管结石。术后出现高淀粉酶血症3例，未见其他并发症。结论成人胆道蛔虫病的发病以中老年为主，易并发胆管结石，ERCP是治疗胆道蛔虫病的有效方法。

Objective To investigate the role of endoscopic retrograde cholangiopancreatography （ERCP） in the diagnosis and treatment of adult biliary ascariasis. Methods Clinical data of 19 cases of adult biliary ascariasis diagnosed and treated with ERCP during Jan 2005 to Dec 2012 were retrospectively analyzed. Results Among the 19 adult patients with biliary ascariasis, 11 were male, and the mean age was （62. 7± 10. 8） years. Eight cases lived in the countryside, 7 cases in the integration of urban and rural area, and 4 cases in urban area. All cases had histories of eating raw fruits and vegetables. Living worms were found in 9 cases. Four cases were complicated with common bile duct stones. Petrification of residual dead worms in the common bile duct was found in 10 cases. All ascariasis and residual bodies were removed successfully by ERCP. There were no postoperative complications except for 3 cases of hyperamylasemia. Conclusions Adult biliary ascariasis commonly occurs in the elderly, and is frequently complicated with common bile duct stones. ERCP is efficacious in treating biliary ascariasis.