十二指肠副乳头插管在ERCP中的应用价值

Application Value of Duodenal Minor Papilla Cannulation in ERCP

目的：探讨十二指肠副乳头插管在ERCP操作中的价值。方法2008年11月～2015年9月，我院行副乳头插管造影及治疗52例，其中胰腺分裂18例，慢性胰腺炎24例，胰管增宽原因待查6例，胰腺假性囊肿1例，怀疑胰腺导管内乳头状肿瘤（ intraductal papillary mucinous neoplasm ，IPMN）2例，胰腺占位性质待查1例。结果52例行63次副胰管插管操作，成功46次，副乳头插管成功率73％（46／63）。35例副乳头插管成功，其中1例接受外科手术，其余34例1个月随访时症状缓解率91％（31／34），半年以上随访时症状缓解率82％（28／34）。结论十二指肠副乳头插管对于主胰管插管失败、胰腺分裂患者是ERCP胰管插管中的一种重要手段，值得推广。

Objective To evaluate the application value of duodenal minor papilla cannulation in ERCP . Methods From November 2008 to September 2015, there were 52 patients in our hospital undergoing duodenal minor papilla cannulation and treatment, including 18 cases of pancreas divisum , 24 cases of chronic pancreatitis , 6 cases of dilation of pancreatic duct with undetermined causes , 1 case of pancreatic pseudocyst , 2 cases of suspected intraductal papillary mucinous neoplasm （ IPMN） , and 1 case of pancreaseoccupying lesions . Results The 52 patients accepted 63 times of minor papilla cannulation , with 46 times of success.The overall success rate was 73%（46/63）.The minor papilla cannulation succeeded in 35 patients.One of them underwent surgical operation .Abdominal pain relieve rate at one month and more than 6 months after operation in the other 34 patients was 91%（31/34） and 82% （28/34）, respectively. Conclusion Minor papilla cannulation is an important option in ERCP procedure in case of failure cannulation of pancreatic duct or pancreas divisum , deserving further clinical application .