双导丝插管术在ERCP胆管插管困难患者中的应用

摘要

目的：通过对内镜逆行胰胆管造影（ERCP）术中选择性胆管插管困难（DSBC）患者应用双导丝插管术进行插管法的分析，探讨在面临胆管插管困难时应用该技术的成功率及相关并发症。方法对2009年8月至2013年4月70例DSBC但导丝又可进入胰管的患者进行分组，双导丝插管组34例应用双导丝插管术进行插管，常规组36例应用常规方法进行插管。结果双导丝插管组34例应用双导丝插管术进行胆管插管成功32例（94.1％），常规组36例成功11例（30.6％），前者高于后者（P＜0.05）；两组并发症分别为3例、10例（P＜0.05）。结论 ERCP术中DSBC患者应用双导丝插管术进行插管可提高插管的成功率，并发症少，值得在临床推广应用。%Objective Toexploresuccessrateandrelatedcomplicationsofapplyingdouble-guide wire technique in endoscopic retrograde cholangiopancreatography (ERCP)when patients encounter the diffi-cultyofselectivebiliarycannulation(DSBC).Methods Atotalof70patientswithDSBCwhereassuccessful entry of guidewire into the pancreatic duct admitted from August 2009 to April 201 3 were enrolled and divided into the double-guide wire technique group (n=34)and the routine intubation group (n=36). Results Thirtytwocases(94.1%)weresuccessfullytreatedwithdouble-guidewiretechniqueand3casespresented with complications. In the routine intubation group,1 1 patients (30.6%)had successful intubation and 1 0 ca-seshadrelevantcomplications(bothP<0.05).Conclusion Double-guidewiretechniquecanimprovethe success rate and yield few complications in treatment of patients suffering from DSBC in ERCP,which is worthy of widespread clinical application.