摘要
目的比较十二指肠镜下胆管腔内超声(IDUS)和内镜下逆行胆管造影(ERC)诊断肝外胆管结石的作用。方法对30例临床怀疑有肝外胆管结石的患者,先进行ERC,再经内镜活检孔道将超声微探头直接送入胆管腔内探查,而后行乳头切开取石。结果30例患者中,ERC准确诊断结石26例,将胆管絮状物诊断为结石1例,漏诊2例,其诊断结石的准确率、敏感性分别为86.7%(26/30)、92.9%(26/28);而IDUS准确诊断结石28例,无漏诊、误诊,其诊断结石的准确率、敏感性均为100.0%。结论IDUS可弥补ERC的视觉误差且在确定胆管结石方面优于ERC。
Objective To compare the diagnostic accuracy of intraductal ultrasonography(IDUS) and endoscopic retrograde cholangiography(ERC) on extrahepatic bile duct stones. Methods 30 patients with suspected extrahepatic bile duct stones by B Ultrasonography, CT,or MRI,were allocated into this study. ERC was performed first by the use of Fujinon duodenal endoscopy ( ED-410XT, ED-410XU) and then followed IDUS by inserting the Fujinon miniprobe (PL2220-15 or PL2226-15) through endoscopic working channel to detect extrahepatic bile duct, finally the substance in extrahepatic bile duct was proved by endoscopic sphincterotomy(EST)and stone extraction. Results Among 30 cases, the diagnoses by ERC were stone 26 cases,floccule 1 cases and misinterpreted 2 cases so the accuracy and sensitivity of ERC were 26/30(86.7%) and 26/28(92.9%)respectively. For IDUS, the diagnoses were totally in accordance with the results of EST and stone extraction.So the accuracy and sensitivity of IDUS in the diagnosis of extrahepatic bile duct stones were 30/30(100%) and 28/28(100%) respectively. Conclusion (1) IDUS was superior to ERC in the diagnosis extrahepatic bile duct stones. (2) IDUS can compensate the misinterpretation of ERC on extrahepatic bile duct stones.
出处
《中华消化内镜杂志》
2002年第3期156-158,共3页
Chinese Journal of Digestive Endoscopy
关键词
内窥镜
胆管腔内超声
逆行胆管造影
诊断
胆管结石
Bile duct, extrahepatic
Calculi
Endoscopic retrograde cholangiopancreatography
Endoscopic ultrasonography
