急性梗阻性化脓性胆管炎的内镜治疗体会(附48例报告)

Endoscopic treatment of acute obstructive suppurative cholangitis

目的 :探讨内镜治疗急性梗阻性化脓性胆管炎 (AOSC)的应用价值。方法 :对 4 8例结石性急性梗阻化脓性胆管炎进行急诊内镜治疗 ,包括逆行胰胆管造影 (ERCP) ,鼻胆管引流 (ENBD) ,乳头括约肌切开 (EST)及取石术。结果 :AOSC内镜引流治疗有效率 10 0 % ,取石成功率为 85 .4 % (4 1/ 4 8) ,余 7例经内镜引流后择期手术。与内镜操作有关的并发症 2例 (4 .17% ) ,均经保守治疗后痊愈。结论 :急性梗阻性化脓性胆管炎应首选急诊内镜胆道引流或、和加上乳头括约肌切开术 (EST) ,其是一种安全、有效的现代微创技术。

Objective:To evaluate the clinical value of endoscopic therapy for acute obstructive supprative cholangitis(AOSC).Methods:48 cases with AOSC caused by bile duct stones underwent endoscopic therapy.The therapeutic endoscopic retrograde cholangiopancreatography(ERCP) included ERCP, endoscopic sphincterotomy.(EST),endoscopic nasobiliary drainage (ENBD)and extracted bile duct stones .Results: The effective rates of endoscopic management were 100%.Bile duct stones were moved out in 41 cases(85.4%),while the rest 7 cases underwent operation after the plenty drainage.Complication related to endoscopy were found in 2 cases (4.17%),Who were cured by the conservation therapy.Conclusions:As a safe , effective, modern therapy with minimal injury, endoscopic bile drainage or/and endoscopic sphincterotomy should be the first choice in case of acute obstructive supprative cholangitis.