经内镜尼龙绳套扎术治疗十二指肠乳头腺瘤的临床评价

Clinical evaluation of endoscopic ligation with nylon snares for adenoma of the major duodenal papilla

目的评价经内镜尼龙绳套扎术治疗十二指肠乳头腺瘤的可行性、安全性及随访结果。方法收集2012年1月-2014年6月于沈阳军区总医院接受治疗的十二指肠乳头腺瘤患者23例,先行经内镜逆行胰胆管造影放置胆管及胰管支架,再应用尼龙绳将肿物完全套扎。内镜定期随访观察肿物有无复发。结果 23例患者胆胰管支架放置及尼龙绳套扎均一次成功,2周内复查内镜肿物均完全脱落;术后并发胆管炎1例(4.3%),胰腺炎2例(8.7%),无出血、穿孔及死亡发生。所有患者术后均随访1年以上,2例腺瘤局部复发。结论经内镜尼龙绳套扎治疗十二指肠乳头腺瘤是一种安全、有效的技术。

Objective To evaluate the feasibility, safety, and follow - up results of endoscopic ligation with nylon snares for adenoma of the major duodenal papilla. Methods Twenty - three patients with adenoma of the major papilla who were treated in our hospital from January 2012 to June 2014 were enrolled as subjects. All patients had biliary and pancreatic duct stents placed by endoscopic cbolangiopancreatography, followed by complete ligation of tumors with nylon snares. Endoscopic follow - up evaluation of recurrence was performed regularly. Results All patients had biliary and pancreatic duct stents successfully placed and tumors successfully ligated with nylon snares in their first surgery. Endoscopic reexamination at two weeks after surgery showed that tumors were removed in all patients. Postoperative complications, cholangitis and panereatitis, were found in one （4.3 % ） and two （8.7 % ） patients, respectively, and there were no bleeding, perforation, or death. A follow - up of more than one year in all patients showed that two patients had local recurrence of adenoma. Conclusion Endoscopic ligation with nylon snares is a safe and effective approach for treating adenoma of the major duodenal papilla.