ERCP治疗胆总管结石的临床分析

目的:探讨内镜逆行胰胆管造影(ERCP)术治疗胆总管结石的临床效果。方法:在内镜下行十二指肠乳头插管,选择性胆道插管成功后造影,根据乳头开口情况行乳头切开,在X线透视下用碎石器或碎石网篮碎石,网篮、气囊取石。结果:内镜下顺利插管并取石25例,插管困难而行针状刀切开后顺利插管并取石10例,经碎石器或碎石网篮碎石后取石12例,失败1例。手术后出现一过性淀粉酶升高4例,引起胰腺炎1例。结论:ERCP对于诊断与治疗胆总管结石具有独特的优势,在临床上具有广阔的应用前景。

The Clinical Analysis of ERCP in the Treatment of Common Bile Duct stones

Objective:To investigate the clinical values of endoscopic retrograde cholangiopancreatography(ERCP)for treating common bile duct stone.Methods:Duodenal papilla intubation was conducted under endoscope.After the success of selective bile duct imaging,endoscopic sphincterotomy(EST) was undergone depend ing on the situa tion.Under the x-ray fluoroscopy the stone was broken with lithotripter or Endoscopic basket lithertrpsy,taken out with w ire basket or ballonet.Results: Twenty-five cases were successfully intubated and lithotomized.Nine cases were intubated after acupotomy due to the difficulty of intubation.Ten cases underwent lithoplaxy with lithotripter or Endoscopic basket lithertrpsy.One case failed.Four cases manifested the increase of amylase after the operation,and 1 of them evoked pancreatitis.Conclusion: ERCP has advantages in the diagnosis and treatment of common bile duct stone.It can be widely applied in clinics.