双导丝插管术在ERCP胆管插管困难患者中的应用

Clinical application of double-guide wire technique in difficult selective biliary cannulation of ERCP

目的通过对内镜逆行胰胆管造影(ERCP)术中选择性胆管插管困难(DSBC)患者应用双导丝插管术进行插管法的分析,探讨在面临胆管插管困难时应用该技术的成功率及相关并发症。方法对2009年8月至2013年4月70例DSBC但导丝又可进入胰管的患者进行分组,双导丝插管组34例应用双导丝插管术进行插管,常规组36例应用常规方法进行插管。结果双导丝插管组34例应用双导丝插管术进行胆管插管成功32例(94.1%),常规组36例成功11例(30.6%),前者高于后者(P<0.05);两组并发症分别为3例、10例(P<0.05)。结论 ERCP术中DSBC患者应用双导丝插管术进行插管可提高插管的成功率,并发症少,值得在临床推广应用。

Objective To explore success rate and related complications of applying double-guide wire technique in endoscopic retrograde cholangiopancreatography （ERCP） when patients encounter the difficulty of selective biliary cannulation （DSBC）. Methods A total of 70 patients with DSBC whereas successful entry of guidewire into the pancreatic duct admitted from August 2009 to April 2013 were enrolled and divided into the double-guide wire technique group （n = 34 ） and the routine intubation group （n = 36 ）. Results Thirty two cases （94. 1% ） were successfully treated with double-guide wire technique and 3 cases presented with complications. In the routine intubation group, 11 patients （30. 6% ） had successful intubation and 10 cases had relevant complications （ both P 〈 0. 05 ）. Conclusion Double-guide wire technique can improve the success rate and yield few complications in treatment of patients suffering from DSBC in ERCP, which is worthy of widespread clinical application.