ERCP对壶腹周围癌的早期诊断价值

Value of ERCP in primary diagnosis of periampullar carcinomas

目的 探讨ERCP对壶腹周围癌的早期诊断价值和合理应用。方法 对我院1997年1月至2002年12月收治的21例典型的壶腹周围癌患者的临床特点和ERCP检查资料进行回顾性统计分析。结果 所有病例均经剖腹手术和病理检查证实为壶腹周围癌,90.5％的患者出现上腹饱胀不适的时间早于黄疸1～2个月,壶腹周围癌的ERCP直接、间接征象和特征性改变明显。结论 重视壶腹周围癌早期非特异性症状,若B超发现阳性征象,应及时、合理地应用ERCP检查,同时结合CT、MRCP等其他影像学方法以达到早期诊断的目的。

Objective To explore the value and rational application of ERCP in primary diagnosis of periampullar carcinomas. Methods The records of 21 patients with periampullar carcinomas (1997.01-2002.12) were analyzed retrospectively, including their clinical characteristics and ERCP imaging features. Results All the cases were convinced to be periampullar carcinomas by surgical therapy and pathological observation. 90.5% of all the patients had upper abdominal distention 1 to 2 months prior to the appearance of jaundice. ERCP direct or indirect signs and characteristic manifestations of periampullar carcinomas are significant. Conclusions It is important to pay great attention to the unspecific symptoms of the epigastrium. If B-ultrosonograph has positive discoveries, it is necessary to use ERCP timely and properly. CT、MRCP and the other imaging techniques should be conducted appropriately in order to discover the disease as early as possible.