摘要
目的探讨SpyGlass DS直视胆道镜系统在胆道疾病诊治中的临床应用价值。方法使用SpyGlass DS直视胆道镜系统对7例胆道疾病患者（包括3例胆总管巨大结石，4例不明原因胆管狭窄）进行镜下诊断和治疗。对胆总管巨大结石患者，行SpyGlass DS胆道镜直视下激光碎石，继之行常规ERCP取石；对不明原因胆管狭窄患者，在SpyGlass DS胆道镜直视下观察病变情况，必要时取活检。结果7例患者均成功完成SpyGlass DS镜下诊治，SpyGlass DS平均操作时间12.6 min。3例胆总管巨大结石患者均成功完成碎石及取石，术后3 d鼻胆管造影显示无结石残留。4例胆管狭窄患者中，2例镜下诊断为恶性胆管狭窄，并被活检病理证实；另外2例镜下诊断为炎性狭窄，未取活检。术后2例患者出现高淀粉酶血症，均自行恢复正常。结论SpyGlass DS能成功用于难治性胆管结石及不明原因胆管狭窄患者的诊治。
ObjectiveTo evaluate the clinical application value of SpyGlass DS cholangioscopy in diagnosis and therapy of patients with biliary tract diseases.MethodsSeven patients with biliary tract diseases were examined and treated with SpyGlass DS system. Three patients with large choledocholithiasis underwent laser lithotripsy under SpyGlass DS system, and then the broken stones were removed by ERCP. Four patients with indeterminate bile duct stricture underwent SpyGlass DS examination and SpyGlass DS-guided biopsies if necessary.ResultsSpyGlass DS cholangioscopy was successfully performed in all patients with a mean procedure time of 12.6 min. Complete stone clearance was achieved in 3 patients with large biliary stones. Of the 4 patients with indeterminate biliary stricture, 2 underwent SpyGlass DS-guided biopsies and were diagnosed as malignant biliary tumor; the other 2 patients were diagnosed as inflammatory bile duct stenosis after visualizing the target lesions without biopsy. Two patients developed hyperamylasemia after the procedure, and recovered spontaneously.ConclusionSpyGlass DS cholangioscopy can provide accurate diagnosis in indeterminate biliary strictures and facilitate therapy in patients with challenging biliary stones.
作者
刘春涛
王拥军
李鹏
冀明
张澍田
Liu Chuntao, Wang Yongjun, Li Peng, Ji Ming, Zhang Shutian(Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University; National Clinical Research Center for Digestive Diseases; Beijing Digestive Disease Center, Beijing 100050, Chin)
出处
《中华消化内镜杂志》
CSCD
北大核心
2018年第5期318-321,共4页
Chinese Journal of Digestive Endoscopy
基金
北京市优秀人才培养资助项目（2015000021469G233）
北京市医院管理局“青苗”计划专项（QML20150105）
