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三镜(腹腔镜、十二指肠镜、胆道镜)联合治疗胰胆疾病
A three-mirror endoscopic technique combining laparoscope, duodenoscope and choledochoscope for treating pancreaticobiliary diseases
文章发布日期:2012年07月11日  来源:  作者:侯玉香 文宗全 钱振育等  点击次数:2295次  下载次数:489次

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【摘要】:目的探讨内镜联合、微创治疗在胰胆疾病中的应用。方法病例筛查,一镜应用(ERCP)、二镜联合、三镜联合应用的指征,术中应注意事项,术后观察并发症等。一镜26例即十二指肠镜(ERCP);二镜方案I:腹腔镜及十二指肠镜7例;二镜方案Ⅱ:腹腔镜+胆道镜17例; 三镜方案10例:十二指肠镜、腹腔镜、胆道镜三者联合应用。结果ERCP 26例,其中2例插管未成功,成功率92.6%。1例2次取石。并发症:2例乳头切开处少量渗血,2例并发高淀粉酶血症。二镜方案I,二镜方案Ⅱ,三镜均操作成功,未出现并发症。结论内镜联合微创治疗取长补短,成功率高,降低了并发症,疗效确切,安全性高,经济实用,体现了微创治疗的优越性。
【Abstract】:ObjectiveTo investigate the benefit of treating pancreatic and biliary diseases with a combination of three commonly used minimally invasive endoscopic techniques, including endoscopic retrograde cholangiopancreatography (ERCP) with stone extraction by endoscopic sphincterotomy(EST), laparoscopic cholecystectomy (LC), and laparoscopic common bile duct exploration (LCBDE). MethodsA total of 60 patients admitted for treatment of pancreatic and biliary diseases were enrolled in the study. According to indications, 26 patients were treated with ERCP alone, 24 patients were treated with a two endoscope combination (two-mirror I: LC plus duodenoscopy, n=7; two-mirror II: LC plus LCBDE, n=17), and ten patients were treated with a three endoscope procedure. Intraoperative events and postoperative complications were recorded. ResultsThe ERCP uniscopic procedure had a success rate of 92.6% (2/26 cases were unsuccessful; 1/26 required a second stone removal). Complications were experienced in 15.4% (4/26) of cases, including two cases with a small amount of bleeding in the nipple incision and two cases with hyperamylasemia. All of the operations using the biscopic procedures (two-mirror I and II) and the triscopic procedure were successful, and none of the recipient patients experienced complications. ConclusionEndoscopic (biscopic and triscopic) combination strategies are highly effective and safe for treating pancreatobiliary diseases.
【关键字】:十二指肠镜;腹腔镜;胆道镜;胆道疾病;胰腺疾病
【Key words】:duodenoscope; laparoscopes; choledochoscope;biliary tract diseases; pancreatic diseases
【引证本文】:

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