新型国产经口胆胰直视化子镜系统临床应用价值的初步分析(含视频)

Clinical value of a new direct visualization system of China-made peroral cholangiopancreatography(with video)

目的探讨新型国产经口胆胰直视化子镜系统诊治胆胰疾病的有效性和安全性。方法回顾性分析2020年4月—2021年6月在南京大学医学院附属鼓楼医院消化内镜中心行国产经口胆胰直视化子镜系统检查的37例患者资料,分析内镜检查的技术成功率和并发症发生情况。结果37例患者均完成国产经口胆胰直视化子镜系统检查,技术成功率100.0%。明确胆管狭窄性质24例,观察胆管有无出血或结石残留6例,观察胰管有无新生物或结石残留2例,直视下辅助导丝通过胆管狭窄2例,直视下辅助胆道激光碎石3例。共9例患者病理确诊为恶性胆管狭窄,其中8例通过经口胆胰直视化子镜系统视觉判断为恶性病变。经口胆胰直视化子镜系统检查后,胆胰管引流34例。术后发生胆管炎3例、菌血症4例、胰腺炎2例,均保守治疗后短期内好转;出血1例,经2次内镜下止血后好转。结论新型国产经口胆胰直视化子镜系统在胆胰疾病诊治中安全、有效。

Objective To investigate the efficacy and safety of a new China-made direct visualization system of peroral cholangiopancreatography in the diagnosis and treatment of biliopancreatic diseases.Methods Clinical data of 37 patients who underwent endoscopic examination through the direct visualization system of peroral cholangiopancreatography at Digestive Endoscopy Center of Nanjing Drum Tower Hospital from April 2020 to June 2021 were retrospectively analyzed.Technical success rate and complications were analyzed.Results The examination was completed in 37 patients through the system.The technical success rate was 100.0%.The nature of biliary stricture was confirmed in 24 cases,presenece or absence of bleeding or residual stones in the bile duct was confirmed in 6 cases,neoplasm or residual stones in the pancreatic duct was determined in 2 cases,biliary stricture was passed assisted with visualized guidewire in 2 cases,and lithotripsy was performed assisted with biliary laser in 3 cases.Nine patients were pathologically diagnosed as having malignant biliary stricture,and 8 of them were confirmed malignant by the system.Drainage was performed in 34 cases after the examination.There were 3 cases of cholangitis,4 cases of bacteremia and 2 cases of postoperative pancreatitis after the operation,which were relieved in a short time after conservative treatment.Bleeding occurred in 1 case which was improved after two times of endoscopic hemostasis.Conclusion The new direct visualization system of peroral cholangiopancreatography is safe and effective in the diagnosis and treatment of biliopancreatic diseases.