经内镜逆行胰胆管造影术后十二指肠穿孔的治疗进展

Progress in treatment of duodenal perforation after ERCP

随着微创外科的发展,经内镜逆行胰胆管造影(endoscopic retrograde cholangiopancreatography,ERCP)因创伤小、恢复快、花费少等优势已经成为诊断和治疗胆胰疾病的重要手段之一。但作为一项侵入性操作,在诊断与治疗的同时会发生一系列相关并发症。其中,十二指肠穿孔是ERCP术后少见却严重的并发症,如果不能尽早处理将会产生严重的后果,甚至危及病人生命。其治疗方式包括保守治疗、内镜治疗和手术治疗,但目前临床上尚缺乏高质量的证据指导治疗方案的选择。作者通过阅读相关文献并结合国内外的治疗进展,对ERCP术后十二指肠穿孔的治疗进行了综述,以期为临床提供参考。

With the development of minimally invasive surgery,endoscopic retrograde cholangiopancreatography(ERCP)has become one of the important methods to diagnose and treat the biliary-pancreatic diseases because of its advantages of less trauma,faster recovery and less cost.However,as an invasive operation,a series of related complications will occur at the same time of diagnosis and treatment.Among them,duodenal perforation is a rare but serious complication after ERCP,which will have serious consequences and even endanger the patient′s life if it cannot be treated as early as possible.Its treatment modalities include conservative treatment,endoscopic treatment,and surgical treatment,but there is still a lack of high-quality evidence in clinical practice to guide the choice of treatment options.Therefore,the author reviewed the treatment of duodenal perforation after ERCP by reading the relevant literature and combining with the treatment progress at home and abroad in order to provide a reference for clinical practice.