【作者】 李兆勇；

【导师】 谢会忠；

【作者基本信息】 新疆医科大学 ， 消化内科， 2007， 硕士

【摘要】 目的:探讨经内镜逆行胰胆管造影(ERCP)和内镜下Oddi括约肌切开(EST)在胆胰疾病诊疗中的应用效果。方法:66例胆胰疾病患者行ERCP 68例次,其中2例行2例次。44例胆道梗阻患者同时行磁共振胆胰管成像(MRCP),分析ERCP的诊疗效果以及与MRCP诊断胆管结石符合率相比较。探讨如何进行ERCP诊断及治疗,提高其成功率及并发症的治疗和预防效果。结果:66例行ERCP诊断胆总管结石31例(41.7%),胆管狭窄18例(27.3%),乳头炎性狭窄11例(16.7%),壶腹癌2例(3.0%),慢性胰腺炎2例(3.0%),乳头旁憩室综合症1例(1.5%),单纯胰管显影1例(1.5%)。ERCP与MRCP诊断胆总管结石差异无统计学意义。出现并发症4例(5.9%),轻型胰腺炎1例,高淀粉酶血症1例,2例EST术后出血,经临床治疗痊愈。结论:ERCP对于胆胰疾病诊断及治疗中具有创伤小、安全有效等特点,在胆胰疾病治疗中具有重要地位。更多还原

【Abstract】 Objective: To investigate the therapeutic effects of endoscopic retrograde cholangiopancreatography(ERCP) and endoscopic sphincterotomy(EST) for cholangiopancreatic disease. Methods: 66 patients with cholecystopancreatic disease underwent ERCP, 2 cases of them underwent ERCP twice, the subsequent EST to remove the stones and to amputate papilla of Vater. Meanwhile in order to analyse the diagnostic and therapeutic effects of ERCP, 44 patients with bile ducts obstruction performed magnetic resonance cholangiopancreatography(MRCP) in compare. Discuss: how to reduce the occurrence of complication, to provide managements of prevention and treatment associated with the ERCP-induced complications. Results: The most frequent cause was cholelithiasis (41.7%),of them stricture of bile duct (27.3%) was the second frequent cause, constrictive papillitis was 3.09%, cancer of ampullae was 3.0%,chronic pancreatitis was 3.0%, periampullary diverticular was 1.5%, endoscopic retrograde pancreatography was 1.5%. These cases underwent ERCP to make the diagnosis of cholecystopancreatic disease and the subsequent EST to remove the stones,to open papilla of Vater. Only 4 patients of them has got the complications including mild pancreatitis in 1 patient, hyperamylasemia in 1 patient ,gastrointestinal bleeding in 2 patient .Patients with these complications were all cured. Conclusion: The advantage of ERCP is micro-invasive, safe and efficient. ERCP has significant value in diagnosing and treating in cholecystopancreatic disease.更多还原