中国内镜杂志2016，Vol.22Issue(12)：75-78,4.DOI:10.3969/j.issn.1007-1989.2016.12.015
胰管导丝占据法与经胆胰管隔膜预切开法在胆总管结石患者困难性内镜下逆行胰胆管造影中的应用
Application of pancreatic duct guide wire and transpancreatic septotomy with precutting techniques in dififcult endoscopic retrograde cholangiopancreatography
金上博 1刘益民 1贺继东 1郭智华 1孙昊2
作者信息
- 1. 陕西省宝鸡市人民医院 肝胆外科，陕西 宝鸡 721000
- 2. 西安交通大学 第一附属医院 肝胆外科，陕西 西安 710069
- 折叠
摘要
Abstract
Objective To investigate the application value of pancreatic duct guide wire and transpancreatic septotomy with precutting technique in difficult endoscopic retrograde cholangiopancreatography.Method258 patients who underwent difficult endoscopic retrograde cholangiopancreatography from April 2014 to April 2016 were selected as study subject, 128 patients among them received the technique of pancreatic duct guide wire, the other 130 patients received transpancreatic septotomy with precutting techniques. The success rate, intubation time and incidence of complications were compared between these two methods for cannulation.Result There was no signiifcant difference in preoperative clinical data between the two groups, the success rate did not differ signiifcantly between the two groups (93.75 % vs 93.85 %). Compared with transpancreatic septotomy with precutting techniques group, pancreatic duct guide wire group is less intubation time consuming (5.92 ± 0.69 vs 12.81 ± 3.67) min, the difference was statistically significant (t = -2.27,P < 0.05). 25 patients experienced complications, with 6 cases of acute pancreatitis, 2 cases of biliray tract infection in pancreatic duct guide wire group, and 8 cases of acute pancreatitis, 3 cases of hemorrhage,6 cases of biliray tract infection in transpancreatic septotomy with precutting techniques group. The pancreatic duct guide wire group had a signiifcantly lower incidence of complications (6.25 % vs 13.08 %). the difference was statistically signiifcant (χ2 = 3.27,P < 0.05). The incidence of acute pancreatitis did not differ signiifcantly between the two groups (4.69 % vs 6.15 %).ConclusionsPancreatic duct guide wire and transpancreatic septotomy with precutting techniques both can further improve the success rate of bile duct cannulation with ERCP. The incidence of acute pancreatitis did not differ significantly between two groups. But pancreatic duct guide wire group is less intubation time consuming, and had a significantly lower incidence of complications. Because of the convenience and safety of the pancreatic duct guide wire technique, and the insertion of the pancreatic duct does not increase the risk of postoperative acute pancreatitis. We think that this method is more worthy of Clinical promotion.关键词
困难性逆行胰胆管造影/胰管导丝占据法/经胆胰管隔膜预切开法/急性胰腺炎Key words
dififcult endoscopic retrograde cholangiopancreatograph/pancreatic duct guide wire technique/transpancreatic septotomy with precutting technique/acute pancreatitis分类
医药卫生引用本文复制引用
金上博,刘益民,贺继东,郭智华,孙昊..胰管导丝占据法与经胆胰管隔膜预切开法在胆总管结石患者困难性内镜下逆行胰胆管造影中的应用[J].中国内镜杂志,2016,22(12):75-78,4.
