内镜下逆行胰胆管造影术在完全性内脏反位中的临床应用价值

Clinical value of endoscopic retrograde cholangiopancreatography in the management of patients with situs inversus totalis

摘要:

目的 评价在完全性内脏反位（SIT）患者进行经内镜逆行胰胆管造影术（ERCP）的有效性和安全性。方法 回顾性分析2008年12月至2018年12月在杭州市第一人民医院消化内镜中心行ERCP治疗的SIT患者的资料，评估插镜成功率、插管成功率、治疗成功率和并发症发生情况。结果 共计有10例SIT患者进行了11例次ERCP术，其中胆总管结石7例，胆总管结石合并胆总管下端狭窄1例，胆总管下端恶性狭窄1例，胆总管下端良性狭窄1例。所有患者采用常规左侧卧位，插镜成功率为100%，胆道插管的成功率为100%，总体治疗成功率为100%，有2例放置金属支架的患者术后出现腹痛，给予保守治疗后好转。结论 在SIT位患者中施行ERCP安全有效。

Abstract:

Objective To evaluate the efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP) for patients with situs inversus totalis (SIT). Methods Clinical data of patients with SIT underwent ERCP at Hangzhou First People"s Hospital from December 2008 to December 2018 were retrospectively collected. The successful intubation rate of the endoscope, success rate of biliary cannulation, success rate of endoscopic procedures and related complications were analyzed. Results A total of 10 patients with SIT underwent 11 times of ERCP. Among these, there were 7 common bile duct stones, 1 common bile duct stones complicating with distal biliary stricture, 1 malignant distal biliary stricture and 1 benign distal biliary stricture. All patients were in left lateral position. The successful intubation rate of the endoscope was 100%, the success rate of biliary cannulation was 100%, and the total success rate of ERCP was 100%. 2 patients had abdomen pain after placement of self-expanding metal stent, and were managed conservatively. Conclusion ERCP is safe and effective for patients with SIT, however, it is recommended to be performed by skilled endoscopists to ensure the success rate and reduce the complication rates.