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ERCP+EST导致十二指肠损伤的诊断及外科治疗

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摘要 目的探讨逆行胰胆管造影+十二指肠乳头括约肌切开术(ERCP+EST)导致十二指肠损伤的诊断及外科治疗方法。方法回顾性分析我院2005-2015年期间10例因行ERCP+EST术治疗胆总管下段结石而并发十二指肠段损伤患者的临床诊治资料。结果 10年间共有1 508例患者因胆总管下段结石接受了ERCP+EST术,10例患者因ERCP+EST术导致十二指肠损伤,发生率约为0.66%。其中2例损伤发生在插管过程中,8例发生在十二指肠乳头括约肌切开时。6例术中发现损伤后立即转入开腹手术,2例为延迟诊断,在术后24 h转入开腹手术,行胆总管T管、胃造瘘、十二指肠造瘘、空肠造瘘及后腹膜引流。有3例附加了十二指肠憩室化手术。4例行后腹膜脓肿清除+引流的二次手术。另有2例术中行十二指肠破口钛夹闭合术,采取保守治疗后痊愈出院。结论 ERCP+EST导致十二指肠损伤患者发病隐匿,病情凶险,预后差,重在预防,但早期诊断并及时正确的治疗能够减少或避免严重不良后果的发生。
出处 《海南医学》 CAS 2015年第21期3213-3215,共3页 Hainan Medical Journal
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参考文献15

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