内镜治疗胆道蛔虫病的临床价值

Clinical value of endoscopic treatment of biliary ascariasis

目的 探讨内镜治疗胆道蛔虫病的临床价值。方法 回顾性分析 10 4例经十二指肠镜治疗的胆道蛔虫病临床资料。结果 7例蛔虫嵌顿于乳头者 ,取虫成功率 10 0 % ;在 97例疑为胆管腔内蛔虫者中 ,直接取虫成功者 2 3例 ,结合ERCP取虫者 74例 ,71例插管成功者中 6 6例经EPBD或EST后取虫成功 ,3例插管不成功而转手术治疗 ;总的成功率 92 .3% (96 / 10 4 )。术后发生急性胆管炎 3例 (2 .9% ) ,急性胰腺炎 1例(0 .9% )。结论 经内镜取虫治疗胆道蛔虫病是一种安全、有效、并发症少的新方法。

Objective: To investigate the clinical value of endoscopic treatment of biliary ascariasis.Methods:The clinical data of 104 cases of biliary ascariasis treated by duodenoscope were analysed retrospectively.Results: In 7 cases of duedenal papilla impaction type,the success rate of duodenoscopic treatment was 100%. Of 97 cases of intrabiliary tract type,23 were treated with duodenoscopy only successfully. Sixty-six was achieved with duedenoscopy combined with EPBD and EST. Surgical treatment were needed in 3 cases. The total success rate of endoscopic treatment was 92.3%(96/104). The rate of acute cholangitis and pancreatitis after treatment was 2.9 % and 0.9 % respectively.Conclusions: Endoscopic treatment of biliary ascariasis is a safe,effective and well tolerated new method.