ERCP治疗在胆道术后早期并发症处理中的临床价值

摘要

目的 探讨经内镜逆行胰胆管造影术(ERCP)及其相关治疗对胆道术后患者早期并发症的临床价值.方法 胆道术后早期出现各种并发症患者206例,经ERCP检查、明确病因后,对胆总管残余结石、胆总管下端狭窄患者行括约肌切开术或乳头球囊扩张术,对胆总管中段狭窄、术后胆瘘患者行内镜下胆道内支架引流或鼻胆管引流.结果 201例ERCP成功病例中4例未发现胆管内异常,5例为十二指肠球部溃疡,治疗胆总管残余结石104例、胆总管下端狭窄32例、胆总管中段狭窄38例和术后胆瘘18例.结论 ERCP能够明确诊断胆道术后早期并发症并给予相应治疗,是术后残余结石、胆总管狭窄及术后胆瘘的有效介入方法.%Objective To evaluate the value of endoscopic retrograde cholangiopancreatography (ERCP) in treating early complications of post-biliary operation. Methods 206 cases after bile duct operation were subjected to ERCP. After aetiology had been made clear, the patients with choledocholithiasis or end biliary structure underwent endoscopic sphincterotomy or endoscopic papillary balloon dilatation; those with middle biliary structure or bile leakage underwent endoscopic retrograde biliary drainage or endoscopic nose-bile drainage. Results ERCP was successful in 201 cases. No obvious biliary abnormality was found in 4 cases; doudenal ulcer was found in 5 cases; 104 cases were cured with choledocholithiasis,there were 32 cases with end biliary structure, 38 cases with middle biliary structure and 18 cases with bile leakage. Conclusion RECP not only reveals the definite causes of complications after biliary operations, but also is effective in taking corresponding endoscopic therapeutic measures.