逆行胰胆管造影术治疗胃切除术后胆总管结石的体会

Experience of ERCP in treatment of choledocholithiasis after gastrectomy

目的总结胃大部切除术后患者进行逆行胰胆管造影术(ERCP)诊治经验,对其手术操作的成功率、安全性和有效性进行评估。方法回顾性分析2010年2月-2016年10月行ERCP治疗的12例胃大部切除术后患者的病历资料。结果 12例患者共成功完成10次ERCP操作,总的ERCP成功率为83.3%(10/12),内镜到达乳头的成功率为91.6%(11/12)。对于插管成功的患者,治疗性操作成功率为83.3%(10/12)。1例患者因空肠输入襻穿孔(8.3%)急诊行手术治疗,无出血、胆漏相关并发症。结论胃大部切除术后患者行ERCP治疗是安全有效的,胃镜、十二指肠镜结合使用,可提高插管成功率和治疗成功率,内镜微创治疗是可行的。

Objective To summarize the treatment experience of patients receiving retrograde cholangiopancreatography(ERCP)after subtotal gastrectomy,and to evaluate the success rate,safety and efficiency of ERCP.Methods A retrospective analysis was made on the medical records of 12 patients who underwent ERCP after subtotal gastrectomy from February 2010 to October 2016.Results 10 ERCP operations were successfully performed on the 12 patients.The overall success rate of ERCP was 83.3%(10/12),and the success rate of endoscopy reaching the nipple was 91.6%(11/12).For patients with successful intubation,the success rate of therapeutic operation was 83.3%(10/12).One patient underwent emergency surgery therapy due to jejunal input haptics perforation(8.3%).No syndromes like hemorrhage or bile leakage occurred.Conclusions Endoscopic minimally invasive therapy is safe and effective for patients after subtotal gastrectomy.The combination of gastroscopy and duodenoscopy can improve the success rate of intubation and treatment.