应用ERCP诊治53例胆道蛔虫病临床效果观察

Clinical application effect of endoscopic retrograde cholangiopancreatography( ERCP)on biliary ascariasis from 53 cases

目的观察内镜逆行胰胆管造影术(ERCP)诊治胆道蛔虫病临床效果,为胆道蛔虫病临床治疗提供科学依据。方法收集2010年1月至2015年5月本院应用ERCP诊治的53例胆道蛔虫病例相关临床资料,并进行回顾性分析。通过取虫成功率、取虫时间、住院天数、并发症以及超声复查发现蛔虫情况等指标对ERCP诊治胆道蛔虫病效果进行观察评价。结果取虫成功率为100%。其中4例乳头嵌塞型病例直接采用网篮或圈套器取虫,取虫平均时间为4.5 min;49例胆管腔内型病例经乳头气囊扩张,采用网篮取虫,平均取虫时间为14.6 min。超声复查均未发现胆道蛔虫,平均住院时间为4.8 d。53例胆道蛔虫病例术后发生并发症8例(15.09%),无消化道出血、穿孔等严重并发症。结论应用ERCP诊治胆道蛔虫病临床效果良好,手术并发症少,值得临床推广。

Objectives To observe the application effect of endoscopic retrograde pancreatic angiography（ ERCP） in diagnosis and treatment for biliary ascariasis and to provide a scientific basis for clinical treatment. Methods The 53 patients with biliary ascariasis were enrolled who were treated by ERCP. The related survey data were collected and retrospectively analyzed. The clinical application effects of ERCP were evaluated by success rate of taking worms,taking time,hospitalization days and complications. Results The success rate of taking worms was 100%.The 4 cases with nipples embedded plug type were directly taken by using a basket with netting on top or snare and the average taking time was 4.5 minutes. The other 49 cases with bile duct type cavity were taken by a basket with netting on top through the papillary balloon expanding and the average taking time was 14.6 minutes. None biliary ascariasis worm was found by type-B ultrasonic review. The average length of hospital stay was 4.8 days. The8 cases with biliary ascariasis had postoperative complications（ counted for 15.09%） and no severe complication such as gastrointestinal bleeding,perforation happened. Conclusion The clinical application effect of ERCP is good for biliary ascariasis diagnosis and treatment. It causes less complication and deserves further dissemination.