中国实用外科杂志2017，Vol.37Issue(11)：1276-1280,5.DOI:10.19538/j.cjps.issn1005-2208.2017.11.22
ERCP在医源性胆管损伤中的治疗价值(附117例报告)
Treatment value of ERCP in bile duct injury after operation: A report of 117 cases
摘要
Abstract
Objective To investigate the application value of ERCP technique in bile duct injury Methods The clinical data of 117 cases of bile duct injury treated with ERCP in the Second Department of General Surgery,the First Hospital of Lanzhou University from January 2007 to August 2016 were analyzed retrospectively.The effect of ERCP in the treatment of different Strasberg types of bile duct injury was analyzed retrospectively.Results All the 117 cases were treated with ERCP,of which type Strasberg-A 56 cases,type C 10 cases,type D 17 cases and type E 34 cases (El 13 cases,E2 10 cases,E3 5 cases and E4 6 cases) repectively.Eighty-seven cases of ERCP had good curative effect;successful rate of ERCP surgery was 74.4％ (87/117).ERCP treatment was nasal biliary drainage combined with plastic biliary stent or metal stent.The postoperative follow-up lasted for 1 years.The effective rate of Strasberg-A,-C,-D,-E type was 100％ (56/56),33.3％ (3/10),94.1％ (16/17) and,35.3％ (12/34) repectively.A total of 30 cases were treated with PTCD drainage and open operations after the endoscopic treatment failure.Among the 87 cases in which the ERCP were successfully implemented,11 cases had postoperative acute cholangitis and 8 cases had acute pancreatitis after ERCP;all of which were cured by conservative treatment;no other complications occurred.Conclusion ERCP has a good effect on biliary tract injury with Strasberg-A.-D type and is less effective in Strasberg-C type combined with right hepatic duct injury.For some Strasberg-E3,-E4 type stenosis and a few Strasberg-E1,-E2 type severe stenosis,ERCP efficacy need to be improved.关键词
内镜逆行胰胆管造影/胆管损伤/引流术/支架Key words
endoscopic retrograde cholangiopancreatography/bile duct injury/drainage/stent分类
医药卫生引用本文复制引用
张辉,周文策,李汛,孟文勃,张磊,苗龙,王正峰,朱克祥..ERCP在医源性胆管损伤中的治疗价值(附117例报告)[J].中国实用外科杂志,2017,37(11):1276-1280,5.基金项目
甘肃省自然科学基金项目资助(No.1606RJZA139) （No.1606RJZA139）
