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Billroth-Ⅱ式胃大部切除术后行经内镜逆行胰胆管造影的安全性分析
Endoscopic retrograde cholangiopancreatography after Billroth-Ⅱ gastrectomy and its safety
文章发布日期:2016年05月06日  来源:  作者:雷婷,聂占国,热合曼,等  点击次数:910次  下载次数:224次

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【摘要】:目的探讨胃Billroth-Ⅱ式术后经内镜逆行胰胆管造影(ERCP)技术及其安全性。 方法对2012年6月-2015年6月兰州军区乌鲁木齐总医院收治的胃Billroth-Ⅱ式术后43例患者行ERCP。 结果43例行ERCP的患者中插管成功39例(907%),插管失败2例(47%),并发消化道穿孔2例(47%)。39例ERCP诊断胆总管结石31例(79.5%),其中3例行乳头括约肌切开术、28例行内镜下乳头球囊扩张术取石;诊断胆管末端良性狭窄6例(15.4%),其中4例行单纯乳头球囊扩张术、2例行胆道塑料支架置入术;诊断壶腹部肿瘤、胃癌肝门部转移各1例(2.6%),分别置入胆道金属支架、塑料支架。术后急性胰腺炎1例(26%)。结论对胃Billroth-Ⅱ式术后患者进行ERCP检查及治疗是安全、有效的,可在临床推广应用。
【Abstract】:Abstract:ObjectiveTo investigate the safety of endoscopic retrograde cholangiopancreatography (ERCP) after Billroth-Ⅱ gastrectomy. MethodsA total of 43 patients who were admitted to our hospital and underwent Billroth-Ⅱ gastrectomy from June 2012 to June 2015 were enrolled and underwent ERCP. ResultsOf all 43 patients undergoing ERCP, 39 (90.7%) received successful intubation, 2 (4.7%) received failed intubation, and 2 (47%) experienced the complication of digestive tract perforation. Among the 39 patients who underwent ERCP, 31 (79.5%) were diagnosed with common bile duct stones (3 underwent sphincterotomy and 28 underwent endoscopic papillary balloon dilation to remove stones), 6 (15.4%) were diagnosed with benign stenosis at the end of bile duct (4 underwent papillary balloon dilation alone and 2 underwent biliary plastic stent implantation), and 1 patient each (2.6%) was diagnosed with ampullary tumor and hepatic portal metastasis of gastric cancer and received implantation of metal and plastic stents, respectively. One patient (26%) experienced acute pancreatitis after surgery. ConclusionERCP is safe and effective in patients after Billroth-Ⅱ gastrectomy and holds promise for clinical application.
【关键字】:胰胆管造影术,内窥镜逆行;胃肠吻合术
【Key words】:cholangiopancreatography, endoscopic retrograde; gastroenterostomy
【引证本文】:雷婷, 聂占国, 热合曼, 等. Billroth-Ⅱ式胃大部切除术后对经内镜逆行胰胆管造影诊疗的影响[J]. 临床肝胆病杂志, 2016, 32(6): 1152-1154.

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