十二指肠隆起性病变的内镜治疗

Emioseopic treatmeut of duodenum elevated lesions

目的分析十二指肠隆起性病变内镜治疗的安全性及有效性。方法对十二指肠隆起性病变患者内镜治疗的临床资料、内镜治疗方法、病理特点、并发症和随访情况进行回顾性分析。结果 112例患者中111例均行内镜治疗,1例中转外科治疗。其中行电凝灼烧术49例,圈套切除术+内镜下黏膜切除术(EMR)36例,内镜黏膜下剥离术(ESD)27例。并发症发生率16.96%(19/112),其中1例因术中大出血,止血困难,中转开腹治疗,7例术中活动性出血,予电热活检钳止血治疗,穿孔6例,迟发性出血2例,一过性淀粉酶升高2例,迟发性穿孔1例。术后随访1~12个月总有效率100.0%。结论内镜治疗十二指肠隆起性病变,具有创伤小、恢复快、费用低和并发症少等优点,内镜治疗将在十二指肠肿瘤中发挥重要的作用。

Objective To assess the curative effect and safety of endoscopic therapy at duodenum elevatedlesions.Methods We retrospectively studied the clinical data including general data,the procedure of performance,the lesions pathological characters,complications and recurrence after the treatment of patients who underwentendoscopic treatment.Results111patients of112patients were treated by endoscopic treatment successfully,1case was treated by surgery.49lesions were treated by electrocoagulation,36lesions were treated by polypectomy orendoscopic mucosal resection(EMR),27by endoscopic submucosal dissection(ESD).Complication rate was16.96%(19/112),1case of active bleeding was treated by surgery in hemostasis difficulty.6cases of perforation,2cases ofdelayed bleeding,2cases of transient increase in amylase level and1case of delayed perforation.All the patientswere successfully performed.Post-operation follow-up period was1~12months.Conclusion Endoscopic treatmentholds advantages of minimally invasive,quick recovery,low cost,and less risk which may be play an important rolein duodenal elevated lesions.