圈套器辅助预切开技术在困难插管内镜逆行胰胆管造影术中的应用

Application of snare-assisted precut technique in difficult cannulation during ERCP

目的探讨一种新的辅助胆管插管技术在内镜逆行胰胆管造影术(ERCP)困难插管中的有效性和安全性。方法在ERCP诊疗过程中,对困难插管的23例病例采用圈套器辅助预切开技术进行胆管插管。观察插管时间、插管成功率、术中术后并发症等指标。结果22例插管成功。术中出血1例,观察后自行停止,无胰腺炎和穿孔发生,无操作相关死亡病例。结论圈套器辅助预切开能充分暴露胆总管,层次更加清楚,操作方法简单,可以作为解决困难插管的一个备选方案。

Objective To explore the effectiveness and safety of a new technique for biliary cannulation in difficult cannulation during ERCP.Methods In the process of ERCP diagnosis and treatment,the snare assisted precut technique was used to assist bile duct intubation in 23 cases with difficult cannulation.The intubation time,success rate of intubation,intraoperative and postoperative complications were observed.Results 22 cases were successfully intubated.Intraoperative bleeding occurred in 1 case and stopped spontaneously.There was no pancreatitis,perforation or operation related death.Conclusion The snare assisted precut can fully expose the common bile duct,with clearer layers and simple operation,which can be used as an alternative to solve the difficult cannulation.