经内镜逆行胰胆管造影术在十二指肠良性狭窄合并胆总管结石中的应用价值

Case analysis of ERCP for benign duodenal stricture and choledocholithiasis

摘要:

目的 分析经内镜逆行胰胆管造影术(ERCP)在十二指肠良性狭窄合并胆总管结石中的有效性及安全性。方法 回顾性分析2013年1月至2017年12月14例因十二指肠良性狭窄合并胆总管结石接受ERCP的患者临床资料。分析病例特点、ERCP情况及预后等。结果 14例患者中ERCP成功12例。共行22次ERCP，平均1.57次/例。8例因十二指肠狭窄接受球囊扩张术。ERCP失败2例均为扩张组患者。ERCP后1例出现轻症急性胰腺炎，1例出现高淀粉酶血症，经药物治疗均康复。14例中有4例于术后1~3年胆总管结石复发，其中3例再次内镜取石成功，1例接受外科手术。结论 ERCP治疗十二指肠良性狭窄合并胆总管结石有较高成功率，但复发率也较高。

Abstract:

Objective To analyze the treatment method, efficacy and safety of ERCP in the treatment of benign duodenal stricture and choledocholithiasis. Methods Between January 2013 and December 2017, 14 patients（4 cases belong to recurrence) with benign duodenal stricture and choledocholithiasis were treated with ERCP in our hospital. Then we analyzed the casecharacteristics, ERCP process and prognosis of these patients. Results 12 cases were successfully treated with ERCP , and the success rate was 85.71% (12/14). A total of 22 ERCP operations were performed, with an average of 1.57 / cases. 8 cases were performed with ballon dilation in the narrow duodenal. There were 1 case of failure in both the expansion group and the non-expansion group.4 cases had recurrence of choledocholithiasis within 1 to 3 years after ERCP, and the recurrence rate was of 28.57%. 3 cases among them had successful ERCP again and 1 case had received surgical operation. After ERCP, 1 case had mild acute pancreatitis, 1 case had hyperamylemia, but all the patients recovered after drug therapy. Conclusions ERCP has a high success rate in patients with benign duodenal stricture and choledocholithiasis，but the recurrence rate is also higher.