SpyGlass单人操作胆道镜系统治疗胆道疾病的初步临床研究

SpyGlass by single-operator in ERCP-guided cholangiopancreatoscopy system for bile-duct disorders

目的探讨SpyGlass单人操作胆道镜系统在治疗胆胰疾病中的应用价值。方法选取巨大胆管结石患者4例，尚未确诊的胆管狭窄患者5例。对胆管巨大结石者，行SpyGlass直视下激光碎石治疗，常规取石。对胆管狭窄者，SpyGlass直视下观察病变情况，SpyBite活检钳直视下活检取样。患者均放置鼻胆引流管，术后检测血常规以及血尿淀粉酶，予抑酸、预防感染治疗。结果9例患者均手术成功，平均SpyGlass操作时间21．2min，平均总操作时间46．2rain。4例巨大胆管结石患者均成功完成碎石及取石，术后2d鼻胆管造影显示无结石残留。5例胆管狭窄患者，病理诊断胆管癌2例，胆管炎性狭窄3例。术后出现胰腺炎2例，均为轻度，经治疗后恢复。结论SpyGlass单人操作胆道镜系统对于胆管疾病的诊治是较为安全有效的。

Objective To evaluate the clinical utility of SpyGlass single-operator ERCP-guided cholangiopancreatoscopy system for the diagnosis and treatment of bile duct disorders. Methods A total of 9 patients with biliary diseases were treated with SpyGlass single-operator ERCP-guided cholangiopancreato-scopy system. Four patients with large bile duct stones accepted laser hthotripsy, and stones were removed by ERCP. Five patients with indeterminate bile duct stricture accepted cholangioscopy-guided sampling. All patients underwent ENBD, routine blood test, blood amylase test, oral food and water restriction, acid sup- pression and prophylactic antibiotics. Results SpyGlass was successful in all patients with a manipulating time of 21.2min and total procedure time of 46. 2min. Complete stone clearance was achieved in all 4 pa-tients with large biliary stones. Sample quality was adequate in all patients with bile duct stricture with 2 pa-tients diagnosed as having malignant biliary tumor and 3 as inflammatory bile duct stenosis. Post-ERCP com plications including mild pancreatitis in 2 patients, and the patients recovered gradually after corresponding treatment. Conclusion ERCP-guided cholangiopancreatoscopy with the SpyGlass system is technically fea-sible and can be successfully and safely performed in patients with biliary disorders.