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内镜逆行胰胆管造影术中使用SpyGlass系统联合液电碎石治疗胆总管困难结石的效果及安全性分析

刘益均 吴乔

刘益均, 吴乔. 内镜逆行胰胆管造影术中使用SpyGlass系统联合液电碎石治疗胆总管困难结石的效果及安全性分析[J]. 临床肝胆病杂志, 2021, 37(7): 1644-1647. DOI: 10.3969/j.issn.1001-5256.2021.07.032
引用本文: 刘益均, 吴乔. 内镜逆行胰胆管造影术中使用SpyGlass系统联合液电碎石治疗胆总管困难结石的效果及安全性分析[J]. 临床肝胆病杂志, 2021, 37(7): 1644-1647. DOI: 10.3969/j.issn.1001-5256.2021.07.032
LIU YJ, W Q. Efficacy and safety of SpyGlass system combined with electrohydraulic lithotripsy during endoscopic retrograde cholangiopancreatography in treatment of difficult common bile duct stones[J]. J Clin Hepatol, 2021, 37(7): 1644-1647. DOI: 10.3969/j.issn.1001-5256.2021.07.032
Citation: LIU YJ, W Q. Efficacy and safety of SpyGlass system combined with electrohydraulic lithotripsy during endoscopic retrograde cholangiopancreatography in treatment of difficult common bile duct stones[J]. J Clin Hepatol, 2021, 37(7): 1644-1647. DOI: 10.3969/j.issn.1001-5256.2021.07.032

内镜逆行胰胆管造影术中使用SpyGlass系统联合液电碎石治疗胆总管困难结石的效果及安全性分析

DOI: 10.3969/j.issn.1001-5256.2021.07.032
详细信息
    通讯作者:

    吴乔,784944194@qq.com

  • 中图分类号: R657.42

Efficacy and safety of SpyGlass system combined with electrohydraulic lithotripsy during endoscopic retrograde cholangiopancreatography in treatment of difficult common bile duct stones

  • 摘要:   目的  评估内镜逆行胰胆管造影(ERCP)术中使用SpyGlass系统联合液电碎石治疗胆总管困难结石的有效性及安全性。  方法  选取2019年12月—2020年5月于重庆医科大学附属第一医院肝胆外科行经内镜逆行胰胆管造影术中使用SpyGlass系统联合液电碎石治疗胆总管困难结石的20例患者,检测术后肝功能、血淀粉酶、血脂肪酶水平;观察患者体温、腹痛以及合并胆道出血、感染、穿孔情况;术后复查是否存在胆总管残余结石。  结果  20例患者中,18例一次性取石成功,无严重手术并发症;2例患者因术后复查见少许残余结石影,再次行ERCP下网篮取石及球囊胆道清理,二次取尽结石。未见胆道穿孔、大出血发生;术后诱发胰腺炎均为轻度,给予药物治疗后好转;部分患者血淀粉酶及脂肪酶水平升高,但无临床症状;术后肝功能均明显好转。所有患者取石术后3个月复查腹部彩超均未见胆总管残余结石。  结论  ERCP术中使用SpyGlass系统联合液电碎石治疗胆总管困难结石一次性取净结石的成功率较高,且无明显手术并发症。

     

  • 图  1  困难结石的CT图像直径测量

    图  2  困难结石的ERCP造影直径测量

    图  3  碎石电极接触结石表面

    图  4  液电击碎结石

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    徐雯, 苗龙, 王正峰, 等. SpyGlass TM DS直视化系统在胆道疾病诊疗中的应用[J]. 临床肝胆病杂志, 2020, 36(11): 2626-2629. DOI: 10.3969/j.issn.1001-5256.2020.11.052.
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  • 收稿日期:  2020-12-30
  • 修回日期:  2021-04-15
  • 刊出日期:  2021-07-20
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