摘要
目的探讨经内镜逆行胰胆管造影术（ERCP）对胆胰疾病的诊疗价值。方法回顾性分析1995年1月至2013年7月间完成ERCP诊治的患者10955例，其中男6186例，女4769例，平均年龄（65．57±14．44）岁。总结并分析ERCP诊治病种、发病年龄、年度数量、麻醉方式及插管成功率等指标。结果10955例患者中，诊断性ERCP167例，治疗性ERCP10788例。2002年至2012年ERCP手术例数年平均增长率是19．58％。首次ERCP胆管插管成功率是97．23％，总ERCP胆管插管成功率是99．59％。常见的ERCP诊治疾病包括肝外胆管结石（40．85％）、肝门部胆管癌（10．53％）、化脓性胆管炎（10．44％）、胰头癌（10．04％）、慢性胰腺炎（8．24％）、肝外胆管癌（7．68％）、壶腹周围癌（6．96％）、胆源性胰腺炎（3．94％）、良性乳头狭窄（3．88％）、乳头癌（3．50％）。肝外胆管结石、化脓性胆管炎、良性乳头狭窄高发年龄是40～50岁，慢性胰腺炎高发年龄是50—60岁，胆源性胰腺炎、肝门部胆管癌、肝外胆管癌、胰头癌、壶腹周围癌、乳头癌的高发年龄是70—80岁。2011年至2013年中，98．74％患者行全凭静脉麻醉ERCP。结论ERCP已经成为胆胰疾病诊治的重要手段，适合于肝外胆管结石、化脓性胆管炎、恶性胆管梗阻等疾病，尤其是高龄患者的诊治。全凭静脉麻醉ERCP是安全、有效的。
Objective To evaluate the clinical efficacy of ERCP in treatment of biliary and pancre- atic diseases. Methods Data of 10 955 patients treated with ERCP from January 1995 to July 2013 were retrospectively analyzed. Results The study cohort consisted of 6186 male and 4769 female, with a mean age of 65. 57 ± 14. 44 years, in which 167 procudures were diagnostic ERCP and 10 788 were therapeutic. The number of ERCP cases increased at an annual average rate of 19. 58% during 2002 to 2012. The initial and total success rate of ERCP cannulation were 97.23% and 99. 59% , respectively. ERCP was used in ex- trahepatic bile duct stone （40. 85% ） , hilar bile duct carcinoma （ 10. 53% ） , acute suppurative cholangitis （ 10. 44% ） , cancer of head of pancreas （ 10. 04% ） , chronic pancreatitis （ 8.24% ） , extrahepatic bile duct cancer （7. 68% ）, periampullary cancer （6. 96% ）, acute pancreatitis with bile duct stones （3. 94% ）, be- nign stenosis of Vater＇s papilla （3.88%） and duodenal papillary cancer （3.50%）. Extrahepatic bile duct stone, acute suppurative cholangitis and benign stenosis of Vater＇s papilla were more common in patients of 40-50 years old, and chronic pancreatitis was more often seen patients of 50-60 years old, while acute pan- creatitis with bile duct stones, hilar bile duct carcinoma, extrahepatic bile duct cancer, cancer of head of pancreas, periampullary cancer, duodenal papillary cancer were more common in patients of 70-80 years old. In the recent 3 years, 98.74% ERCP procedures was done under total intravenous anesthesia （TIVA）.Conclusion ERCP is a key method for diagnosis and treatment of extrahepatic bile duct stone, acute suppu- rative cholangitis and malignant biliary obstructive disease, especially for extremely elderly patients. ERCP under total intravenous anesthesia is safe and effective.
出处
《中华消化内镜杂志》
2013年第11期621-625,共5页
Chinese Journal of Digestive Endoscopy
关键词
胰胆管造影术
内窥镜逆行
胆道疾病
胰腺疾病
麻醉
静脉
Cholangiopancreatography, endoscopic retrograde
Biliary tract diseases
Pancreat-ic diseases
Anesthesia, intravenous
