ERCP术治疗胆总管结石的有效性及安全性分析

Analysis of the Effectiveness and Safety of Endoscopic Retrograde Cholangiopancreatography in the Treatment of Choledocholithiasis

目的:分析经内镜逆行胰胆管造影术(ERCP)术治疗胆总管结石的有效性及安全性。方法:选择2017年1月~2018年8月在我院接受择期ERCP治疗的164例胆总管结石患者为研究对象,分析患者的手术情况、取石效果、手术前后胃肠疾病生活质量指数(GIQLI)量表评分和并发症的发生情况。结果:胆总管结石患者手术时间为(37.90±4.21)min、术中出血量(10.86±1.29)mL、术后通气时间(4.38±0.65)d、切口疼痛时间(1.02±0.12)d、住院时间(8.62±0.96)d、手术成功率为97.56%(160/164)、一次取净结石率为95.73%(157/164)、二次取净结石率为1.82%(3/164)。术后,胆总管结石患者GIQLI评分均显著高于术前(P<0.05)。胆总管结石患者术后发生胰腺炎5例、胆管炎1例、出血6例、高淀粉酶血症4例。结论:ERCP术是胆总管结石患者的有效治疗手段,但需积极预防并处理相关并发症。

Objective:To analyze the efficacy and safety of endoscopic retrograde cholangiopancreatography(ERCP)in the treatment of choledocholithiasis.Methods:164 cases of choledocholithiasis patients who were treated by elective ERCP in our hospital from January 2017 to August 2018 were selected as the research objects,the operation condition,stone effect,gastrointestinal disease quality of life index(GIQLI)scale before and after surgery,and the incidence of complications were ananlyed.Results:The operation time of patients with choledocholithiasis was(37.90±4.21)min,the intraoperative blood loss was(10.86±1.29)m L,the postoperative ventilation time was(4.38±0.65)d,the incision pain time was(1.02±0.12)d,the length of hospital stay was(8.62 0.96)d,the success rate of surgery was 97.56%(160/164),the stone removal rate was 95.73%(157/164),and the stone removal rate was 1.82%(3/164).Before surgery,the GIQLI scores of patients with common bile duct stones were all higher than those before surgery(P<0.05).There were 5 cases of pancreatitis,1 case of cholangitis,6 cases of bleeding and 4 cases of hyperamylase in the patients with choledocholithiasis.Conclusion:ERCP is an effective treatment for choledocholithiasis,but the related complications should be actively prevented and managed.