存有严重并发症的急性化脓性胆管炎的急诊内镜治疗

Treatment Experience of Acute Suppurative Cholangitis in Patients with Severe Medical Condition under Endoscopy

目的 探讨有严重并发症的急性化脓性胆管炎急诊内镜治疗的价值。方法 对 18例有严重并发症的急性化脓性胆管炎进行急诊内镜治疗 ,治疗方法包括逆行胰胆管造影 (endoscopicretro gradecholangiopancreatography ,ERCP)、鼻胆管引流 (endoscopicnasobiliarydrainage,ENBD) ,和 (或 )乳头括约肌切开术 (endoscopicsphincterotomy ,EST)及取石术、胆道内支架置入术。结果 18例患者经急诊内镜治疗 ,完成治疗 17例 ,成功率 94 .4 %。取石成功 14例 (82 .4 % ) ,单纯鼻胆管引流 2例 ,胆总管塑料支架置入 2例。产生与内镜有关的并发症 1例 (5 .9% ) ,无死亡病例 ,治愈率为 88%。结论 急诊内镜治疗存有严重并发症的急性化脓性胆管炎创伤小、治愈率高、并发症少 。

Objective To explore the effectiveness of endoscopic treatment in acute suppurative cholangitis with severe medical conditions. Methods Endoscopic therapy was given to 18 patients associated severe medical conditions diagnosed acute cholangitis. The therapy included ERCP,ENBD,EST and biliary endoprosthesis. Results 17 cases completed therapy (94.4%), bile duct stones were moved in 14 cases (82.4%), 2 patients received ENBD only, 2 patients underwent biliary endoprosthesis.The curative rate of cholangitis was 88%. Conclusions Endoscopic biliary tract drainage or combined with EST is the first choice to acute cholangitis associated severe medical conditions. It is a safe, quick and effective therapy.