胃、十二指肠术后常见并发症的内镜诊断与治疗

Endoscopic diagnosis and treatment for common complications of post gastroduodenal operation

目的 总结 136例胃、十二指肠疾病手术后常见并发症的内镜诊治经验。方法 对 136例病人术后并发症的内镜诊断与治疗进行回顾性总结分析。结果 136例中吻合口或残胃溃疡 2 9例 4 5个 ,吻合口输出段良性瘢痕狭窄伴梗阻 6例 ,吻合口糜烂伴残留缝线反应 72例 ,胃息肉 9例 31枚 ,残胃癌 3例 ,癌性狭窄 17例 ;其中 9例转入外科治疗 ,采用内镜治疗 12 7例中治愈 10 4例 (81 89% ) ,显效 9例 (7 0 9% ) ,有效 5例 (3 94 % ) ,缓解 7例 (5 5 1% ) ,无效 2例 (1 5 7% )。结论 经内镜诊断与治疗胃、十二指肠疾病术后并发症 ,具有诊断正确、定位精确、治疗适应证广泛、疗效确切等优点 。

Objective To sum up the experience of diagnosis and treatment in common complications of 136 cases of post gastroduodenal operations.Methods The diagnosis and treatment for postoperative complications of 136 cases were retrospectively analyzed.Results Among 136 cases,45 ulcers located in stoma and gastric remnant were found in 29 patients.Benign scar constriction acompanying obstruction was presented in stoma outer segment of 6 cases.Stoma erosion with suture reaction,31 gastric polyps and gastric remnant cancer as well as malignant constriction appeared in 72,9,3 and 17 cases,respectively.Of 136 patients,9 were changed to surgical management,and 127 were treated by endoscope in which 104 cases were cured(81.89%),and 21 cases were bettered(16.54%),but 2 cases appeared no effect(1.57%),demonstrating a 98.43% of treatment effective rate.Conclusion To diagnoze and treat complications of post gastroduodenal operation with endoscope has such advantages as precise diagnosis and location,broad indications,definite treating result and so on,which shows greater clinical value.