摘要
目的评价ERCP插管过程中导丝所致十二指肠乳头穿孔时使用双导丝技术胆管插管的效果及安全性。方法2008年1月至2016年9月，57例ERCP插管过程中导丝所致十二指肠乳头穿孔病例纳入回顾性研究，其中采用双导丝技术行胆管插管30例（双导丝组）、传统方法继续胆管插管27例（标准组），总结并比较2组的插管成功率、插管时间及并发症发生率。结果双导丝组插管成功率[96.7%（29/30）]明显高于标准组[74.1%（20/27），χ2＝5.545，P＝0.019]，平均插管时间[（21.8±7.8）min]明显短于标准组[（40.7±8.4）min，t＝8.076，P＝0.000]，并发症发生率[13.3%（4/30）]与标准组[11.1%（3/27），χ2＝0.292，P＝0.596]相近，均为术后高淀粉酶血症。结论ERCP插管过程中导丝所致十二指肠乳头穿孔时使用双导丝技术胆管插管安全且有效，较之传统方法具有插管成功率更高且省时的优势。
ObjectiveTo evaluate the efficacy and safety of double guidewire technique in perforation of duodenal papilla caused by guide wire during endoscopic retrograde cholangiopancreatography （ERCP） intubation.MethodsA retrospective analysis was performed on data of 57 patients whose duodenal papilla were perforated by guidewire in ERCP from January 2008 to September 2016. Among the 57 patients, 30 patients were cannulated with double guidewire technique （double guidewire group） and 27 patients were performed with traditional technique （standard group） for continue. The biliary intubation success rate, intubation time, and post-ERCP complication rate were compared between the two groups.ResultsThe rate of successful intubation of the double guidewire group was significantly higher than that of the standard group[96.7% （29/30） VS 74.1% （20/27）, χ2=5.545, P=0.019]. The intubation time of the double guidewire group was significantly shorter than that of the standard group （21.8±7.8 min VS 40.7±8.4 min, t=8.076, P=0.000）. The double guidewire group had a similar incidence of post-ERCP complication compared to the standard group[13.3% （4/30） VS 11.1% （3/27）, χ2=0.292, P=0.596], and the complication in two groups was hyperamylasemia.ConclusionDouble guidewire technique is safe and effective for difficult biliary cannulation because of perforation of duodenal papilla with a higher success rate and less time compared to classic technique.
作者
于剑锋
张冬磊
郝建宇
Yu Jianfeng;Zhang Donglei;Hao Jianyu(Department of Gastroenterology,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)
出处
《中华消化内镜杂志》
CSCD
北大核心
2018年第11期838-841,共4页
Chinese Journal of Digestive Endoscopy
关键词
胰胆管造影术
内窥镜逆行
插管法
胆管
十二指肠乳头
Cholangiopancreatography
endoscopic retrograde
Cannulation
Bile ducts
Duodenal papilla
