摘要
我院从2005年1月至2008年12月共对1263例胆总管结石患者行经内镜逆行胰胆管造影术联合十二指肠乳头括约肌切开术.共有1235例取石成功,成功率97.8%,做十二指肠乳头括约肌切开后1次取石成功982例,2次取石成功129例,3次及以上取石成功124例.术后放置鼻胆引流管1130例,占89.5%.有56例患者取石困难行置入胆道塑料内支架,其中42例经1～3次更换内支架后取尽.共28例取石失败转外科手术治疗.术后并发症29例,发生率2.3%,其中切口出血8例,急性胰腺炎17例（其中重症5例）,穿孔4例.无患者死亡.提示绝大部分胆总管结石可通过内镜治疗取尽,但对肝内胆管结石及难取性胆总管结石是治疗难点,同时其远期疗效、并发症情况需要进一步探索研究.
1263 patients with choledocholithiasis were treated with endoscopic retrograde cholangiopancreatography （ERCP） and endoscopic sphincterotomy （EST） from January 2005 to December 2008, with 1235 （97.8%） cases successfully treated. One-time ERCP removal of the stones was successful in 982 patients, with two times in 129 patients and three times in 124. 1130 patients （89. 5% ） underwent endoscopic nasal biliary drainage （ENBD） after the procedure. 56 patients with refractory stone were treated with intrabiliary plastic stent, among whom 42 were cured through endoscopic retrograde biliary drainage （ERBD） of 1 -3 times. Complications occurred in 29 patients （2. 3% ） with hemorrhage in 8 patients,acute pancreatitis in 17 and perforations in 4. Mortality rate was 0. We concluded that the majority cases of choledocholithiasis can be successfully treated by ERCP, while intrahepatic cholelithiasis and refractory common bile duct stone remained therapeutic challenges. It is also mandatory to evaluate long-term efficacy and complications of ERCP.
出处
《中华全科医师杂志》
2010年第8期564-566,共3页
Chinese Journal of General Practitioners
关键词
胆总管结石
胰胆管造影术
内窥镜逆行
Choledocholithiasis
Cholangiopancreatography,endoscopic retrograde
