内镜逆行胰胆管造影联合SpyGlass在Ⅰ型Mirizzi综合征中的应用

Application of endoscopic retrograde cholangiopancreatography combined with SpyGlass in type Ⅰ Mirizzi syndrome

目的 评估内镜逆行胰胆管造影术(ERCP)联合SpyGlass在Ⅰ型Mirizzi综合征中应用的有效性及安全性。方法 回顾性收集2018年1月至2021年12月山东省立第三医院20例Ⅰ型Mirizzi综合征患者行内镜治疗的临床资料,分析ERCP成功取石率、ERCP治疗次数、SpyGlass碎石次数、结石取净率、并发症发生率以及结石复发情况。结果 共有20例患者纳入研究,结石直径为(0.70±0.19)mm,结石个数为(1.45±0.68)个,总ERCP成功取石率为90%(18/20),其中18例患者中ERCP次数(1.10±0.30)次,SpyGlass碎石次数(1.05±0.22)次,结石取净率100%(18/18),20例中共有1例发生ERCP术后胰腺炎,无出血、穿孔等并发症发生。术后规律口服利胆药物3个月,随访6~30个月,无结石复发。结论 ERCP联合SpyGlass直视系统在Ⅰ型Mirizzi综合征中应用是安全有效的。

Objective To evaluate the efficacy and safety of endoscopic retrograde cholangiopancreatography(ERCP)combined with SpyGlass in the treatment of typeⅠMirizzi syndrome.Methods Clinical data of 20 patients with Mirizzi syndrome typeⅠwho underwent endoscopic treatment at Shandong Provincial Third Hospital from Jan.2018 to Dec.2021 were collected.The success rate of ERCP,frequency of ERCP treatment,frequency of SpyGlass lithotripsy,rate of stone removal,incidence of complications,and recurrence of stones were analyzed.Results A total of 20 patients were included in the study,with a stone diameter of(0.70±0.19)mm and a number of stones of(1.45±0.68).The overall success rate of ERCP stone removal was 90%(18/20),with an average ERCP frequency of(1.10±0.30)times and an average SpyGlass lithotripsy frequency of(1.05±0.22)times.The stone clearance rate was 100%(18/18),and one patient developed post-ERCP pancreatitis with no bleeding,perforation,or other complications.After operation,regular oral cholelitics for 3 months,follow-up for 6 to 30 months,no recurrence of stones.Conclusion The application of ERCP combined with SpyGlass direct visualization system in type I Mirizzi syndrome is safe and effective.