超声内镜与内镜逆行胰胆管造影联合检查对胆总管壶腹区病变的诊断价值

目的 探讨超声内镜、内镜逆行胰胆管造影（ERCP）联合检查对胆总管壶腹区病变的诊断价值.方法 91例患者均行B型超声、CT及超声内镜检查,部分行ERCP检查.并将超声内镜及超声内镜联合ERCP与B型超声、CT、ERCP对胆总管壶腹区病变诊断结果进行比较.结果 超声内镜、ERCP对胆总管壶腹区病变诊断的阳性率分别为94.5%（86/91）、90.2%（74/91）.超声内镜诊断胆总管结石及慢性胰腺炎的准确率为100%,超声内镜联合ERCP检奁对结石及肿瘤的诊断阳性率分别为100%、97%.结论 超声内镜对胆总管壶腹区病变的诊断率高于腹部B型超声、CT及ERCP,联合ERCP对病变的定位及定性诊断有较高的价值,指导规范临床治疗.

The value of endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography in diagnosis of ampulla of vater diseases of the common bile duct

Objective To evaluate the clinical value of endoscopic ultrasonography (EUS) and endoscopic retrograde cholangiopancreatography(ERCP) in diagnosis of the ampulla of Vater diseases of the common bile duct.Methods B-mode uhrasonography(B-US), computerized tomography(CT) and EUS were performed in all patients with ampulla of Vater diseases of the common bile duct.ERCP was performed in some of the patients.The accuracy of diagnosis was compared among examinations by EUS, EUS combined with ERCP, B-US, CT.Results The positive rates of EUS and ERCP are 94.5% (86/91) and 90.2% (74/91) respectively.The accuracy of EUS in diagnosis of common duct stones and chronic pancreatitis was 100%.The accuracy of EUS combined with ERCP examination in diagnosis of common duct stones and tumors is 100% and 97% respectively.Conclusions EUS has a higher accuracy in the diagnosis of the ampulla of Vater diseases of the common bile duct than B-US, CT and ERCP.EUS combined with ERCP can gain higher value in localization and qualitative diagnosis of the ampulla of Vater diseases of the common bile duct.