摘要
目的探讨乳头括约肌预切开术在内镜逆行胰胆管造影术(ERCP)中的应用价值,对其在ERCP诊断和治疗中的作用和安全性作回顾性评价。方法67例患者在实施ERCP诊疗操作中,当常规方法不能使胆系显影或胆道深部插管困难时,即用标准刀(经胰管)、犁状刀或针状刀行乳头预切开,观察预切开的效果和近期并发症。结果全组67例行预切开后,ERCP诊治成功58例,成功率86.6%。其中标准刀(经胰管)组成功率84.6%;犁状刀组成功率85.7%;针状刀组(开窗术)成功率100%。术后并发症3例(4.5%),包括出血2例,轻度胰腺炎1例。结论乳头括约肌预切开术是ERCP诊疗困难时成功进入胆道的一项极有效的技术手段。
Objective To discuss the clinical value of precut sphincterotomy （PST） in ERCP, with a retrospective evaluation of the efficacy and safety of PST during diagnostic ＆ therapeutic ERCP. Methods With a standard papillotome （transpancreatic duct pre - cut）, a plough - like papillotome or a needle - knife papillotome, immediate PST was carried out in 67 patients recently when conventional method was not able to visualize the biliary tract or deep cannulations proves difficult during ERCP.The follow - up concentrated on the efficacy of the procedure and short - term complication. Results ERCP was successful after PST was performed in 58 of 67 patients in whom attempts at conventional method were failed, total success rate was achieved in 86.6%. The success rates of the standard papillotome team （transpancreatic duct pre - cut） were 84.6%, the plough- like papillotome team 85.7%, the needle -kinfe papillotome team （fistulotomy） 100% .The complications of PST occur in 3（4.5 % ） of patients, including mild bleeding in 2 patients and mild panereatids in 1. Conclusion Precut sphincterotomy is a highly effective method to gain biliary access during diagnostic ＆ therapeutic ERCP when which are difficult, but should be carried out by experts only.
出处
《宁夏医学杂志》
CAS
2006年第10期740-742,共3页
Ningxia Medical Journal
关键词
内镜逆行胰胆管造影
括约肌预切开术
Endoscopic retrograde cholangiopancratography
Precut sphincterotomy
