取石球囊负压吸引造影法辅助导丝插入在胆管结石嵌顿中的应用

Application of balloon suction radiography-assisted guidewire insertion in management of incarcerated stones in the common bile duct

目的:探讨取石球囊负压吸引造影法辅助导丝插入在内镜逆行胰胆管造影术(endoscopic retrograde cholangio pancreatography,ERCP)胆管中上段结石嵌顿中的应用.方法:回顾性分析2005-06/2012-01我院收治的15例ERCP术中发现胆管结石嵌顿于胆管中上段的患者临床资料,我们创新运用取石球囊负压吸引造影法辅助导丝插入.结果:本组患者中,ERCP造影成功率为100%(15/15),皆成功将导丝越过嵌顿结石,术后发生胰腺炎1例,高淀粉酶血症,保守治疗2-5 d后痊愈,未发生出血和穿孔并发症.结论:取石球囊负压吸引法辅助导丝插入在合并胆管中上段结石嵌顿的患者中简单易行,提高成功率,减少操作时间,是一种安全有效的操作方法.

AIM： To assess the application of balloon suction radiography-assisted guidewire insertion in endoscopic retrograde cholangiopancreatography （ERCP） in patients with incarcerated stones in the upper or middle segment of the common bile duct. METHODS： Clinical data for 15 patients with incarcerated stones in the upper or middle segment of the common bile duct who underwent radiography-assisted guidewire insertion in ERCP at our hospital from June 2005 to January 2012 were retrospectively analzyed. RESULTS： Radiography was successful in all 15 patients, and the guidewire went through the incarcerated stones in each patient. After ERCP, one patient developed acute pancreatitis and hyperamylasemia but recovered after receiving medical treatment for 2-5 d. No bleeding or perforation occurred. CONCLUSION： Balloon suction radiography-assisted guidewire insertion can reduce operative time and improve the success rate and safety in patients with incarcerated stones in the common bile duct.