摘要
目的探讨诊断性及治疗性ＥＲＣＰ早期并发症发生情况及处理。方法回顾总结了我院２３年间８ ５７９例次诊断性与治疗性ＥＲＣＰ临床资料，分析了早期并发症发生情况、种类、处理及预后。结果２３年间８ ５７９例ＥＲＣＰ诊疗中，共发生早期并发症１１２例（１．３１％），其中诊断性ＥＲＣＰ发生率为１．３０％（９５／７２９０），治疗性ＥＲＣＰ为１．３２％（１７／１ ２８９），并发水肿型胰腺炎３８例（０．４４％），胆道感染３０例（０．３５％） ，消化道大出血２６例（０．３０％），药物反应８例（０．０９％），结石及取石篮嵌顿５例（０．０６％），肠穿孔３例（０．０３％），急性出血坏死型胰腺炎１例（０．０１％），后腹膜腔积气１例（０．０１％）。１１２例并发症中，经内科保守治疗痊愈１０６例（９４．６％），外科手术治疗５例（４．５％），１例死亡。结论诊断性ＥＲＣＰ并发症中以急性胰腺炎发生率为高，可能与插管困难、反复显影、注射造影剂压力过大、量过多有关，治疗性ＥＲＣＰ并发症中以出血为常见，与操作技术、伴有黄疸及糖尿病等因素有关，绝大多数并发症可经内科保守治疗而得以痊愈，仅极少数患者需外科手术处理。
Objective To investigate the occurrence of early complications of diagnostic and therapeutic ERCP and its treatment .Methods Occurrence,kind,treatment and outcome of early complications of diagnostic and therapeutic ERCP were respectively reviewed in 8 579 cases in our hospital between January 1977 and December 1999.Results 112 cases had early complications(1.31%).In diagnostic ERCP morbidity of early complications was 1.30%(95/7290) and it was 1.32%(17/1289)in therapeutic ERCP.Of them,acute pancreatitis occurred in 38 cases(0.44%),billiary infection 30 cases(0.35%),bleeding of digestive tract 26 cases(0.30%),drug reaction 8 cases(0.09%),stone and basket incarceration 5 cases(0.06)%,intestinal perforation 1 cases (0.01%) and retroperitoneal pneumatosis 1 cases(0.01%).Of them,106 patients were cured by conservative therapy.Operations were performed in 5 patients.1 patient died.Conclusion In diagnostic ERCP acute pancreatitis is the most common complication,which may be related to difficulty of cannulation,repeated developing and inappropriately injecting contrast medium. In therapeutic ERPC bleeding of digestive tract is the most common complication ,which is related to the procedure ,jaundice and diabetes.Most of complications can be cured by conservative therapy,but a minority needs operation.
出处
《中华消化内镜杂志》
2002年第2期77-80,共4页
Chinese Journal of Digestive Endoscopy
关键词
内窥镜逆行胰胆管造影术
并发症
处理
Cholangiopancreatography, Endoscopic retrograde
Complications
Treatment
