胆肠吻合术后胆管结石内镜治疗疗效评估(附17例报告)

Diagnostic and therapeutic endoscopy for biliary stones following bilioenterostomy:A report of 17 patients

目的评估内镜逆行胰胆管造影(ERCP)治疗胆肠吻合术后并发胆管结石的成功率、安全性和有效性。方法回顾性分析2012年4月至2014年3月上海交通大学医学院附属新华医院行ERCP治疗17例胆肠吻合术后胆管结石病人的临床资料。结果 17例病人中,胆肠Roux-en-Y吻合术后病人13例,胰十二指肠切除术后胆管空肠吻合病人4例。成功进入空肠输入袢到达胆肠吻合口14例(82.4%)。4例行诊断性ERCP,10例为治疗性操作,均成功行取石+经内镜鼻胆管引流术(ENBD)。无消化道穿孔及出血相关并发症。结论对于胆肠吻合术后胆管结石的病人,使用ERCP进行诊治安全、可行。

Objective To evaluate the successful rate, safety and efficiency of endoscopic retrograde cholangiopancreaticography （ERCP） for biliary stone following bilioenterostomy. Methods The clinical data of 17 patients with biliary stone following bilioenterostomy underwent ERCP from April 2012 to March 2014 in Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were analyzed retrospectively. Results Among 17 patients, 13 patients were performed Roux-en-Y bilioenterostomy and 4 patients were performed duodenopancreatectomy. In 14 of 17 patients, afferent loop intnbation and selective cannulation of biliary duct was successful in 82.35% and 100% respectively. Procedure of diagnosis was carried out in 4 patients, and therapeutic in 10 patients who underwent stone removal ＋ endoscopic nasobiliary drainage （ENBD）. There was no complication of perforation and bleeding in all patients. Conclusion ERCP for biliary stone following bilioenterostomy is safe and efficient.