经内镜逆行胰胆管造影术治疗肝硬化合并胆胰疾病的价值
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1.成都市第三人民医院消化内科;2.首都医科大学附属北京友谊医院 消化内科;3.四川省大竹县人民医院 消化内科;4.中国人民解放军空军军医大学 西京消化病医院 消化六科

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国家自然科学基金(81902398)


Therapeutic value of endoscopic retrograde cholangiopancreatography for liver cirrhosis combined with biliopancreatic diseases
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Affiliation:

The third people''s Hospital of Chengdu

Fund Project:

National Natural Science Foundation of China (81902398)

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    摘要:

    目的 评价肝硬化合并胆胰疾病患者行经内镜逆行胰胆管造影术(endoscopic retrograde cholangiopancreatography,ERCP)治疗的疗效和安全性。 方法 回顾性分析西京消化病医院2008年11月至2017年12月期间因肝硬化合并胆胰疾病行ERCP的初治患者99例的病例资料,分析ERCP成功率及并发症发生情况。 结果 99例肝硬化患者以乙肝病毒感染(40.4%,40/99)和病因不明(30.3%,30/99)为主,终末期肝病模型(model for end-stage liver disease,MELD)评分(15.4±5.3)分;胆胰疾病以胆总管结石和胆管狭窄为主,分别占49.5%(49/99)和33.3%(33/99)。ERCP治疗成功率为100.0%(99/99)。术后总体并发症发生率为14.1%(14/99),其中肝硬化相关并发症发生率为3.0%(3/99);ERCP相关并发症发生率为11.1%(11/99),包括胆道感染(9.1%,9/99)和迟发性出血(2.0%,2/99)。无ERCP术后胰腺炎、穿孔及ERCP相关死亡。 结论 肝硬化合并胆胰疾病患者行ERCP治疗是安全有效的。

    Abstract:

    Objective To evaluate the efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP) for patients with liver cirrhosis combined with biliopancreatic diseases. Methods Data of 99 patients with liver cirrhosis combined with biliopancreatic diseases who received ERCP at Xijing Digestive Hospital from November 2008 to December 2017 for the first time were retrospectively studied. Success rate of ERCP and incidence of complications were analyzed. Results The 99 cases of liver cirrhosis were mainly caused by hepatitis B virus infection (40.4%, 40/99) and unknown reasons (30.3%, 30/99), and the mean model for end-stage liver disease score was 15.4±5.3. The common bile duct stones and bile duct stricture were the most common biliopancreatic diseases, accounting for 49.5% (49/99) and 33.3% (33/99), respectively. The success rate of ERCP was 100.0%(99/99). The total postoperative complication incidence was 14.1% (14/99), among which liver cirrhosis-related complications was 3.0% (3/99); ERCP-related complications was 11.1% (11/99), including 9.1% (9/99) biliary tract infection, and 2.0% (2/99) delayed bleeding. No post-ERCP pancreatitis, perforation or death occurred. Conclusion ERCP is safe and effective for liver cirrhosis combined with biliopancreatic diseases.

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冉文斌,李婕琳,甘洁婷,等.经内镜逆行胰胆管造影术治疗肝硬化合并胆胰疾病的价值[J].中华消化内镜杂志,2020,37(2):121-124.

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  • 收稿日期:2018-10-23
  • 最后修改日期:2019-12-29
  • 录用日期:2018-11-22
  • 在线发布日期: 2020-03-04
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