摘要
目的:探讨双导丝技术(DGT)与早期经胰管乳头括约肌切开术(TPS)在困难性胆管插管(DSBC)ERCP中的应用。方法:选取2013年1月~2019年1月在重庆市黔江中心医院行ERCP插管时DSBC患者152例,根据插管方法分为单导丝技术(SGT)组(对照组)、DGT组和TPS组,比较3组患者插管时间、成功率及并发症发生率。结果:DGT组、TPS组的插管时间分别为(6.47±1.84)min、(5.29±2.01)min,显著低于SGT组的(8.17±2.34)min,差异有统计学意义(P<0.05)。DGT组、TPS组的成功率分别为84.45%、93.75%,显著高于SGT组(76.09%),差异有统计学意义(P<0.05)。DGT组术后并发症发生率12.07%,TPS组并发症发生率20.83%,SGT组并发症发生率30.43%,DGT组和TPS组与SGT组比较差异均有统计学意义(P<0.05)。结论:选择性胆管插管困难而导丝进入胰管时继续SGT成功率低且并发症发生率较高,经DGT、TPS均可有效提高插管成功率,且并发症发生率均相对较低。
Objective To evaluate the applicability of double guidewire technique (DGT) vs early transpancreatic precut sphincterotomy (TPS) for cannulation in difficult bile duct cannulation (DSBC) in endoscopic retrograde eholangiopancreatography (ERCP). Method Retrospective analysis of 152 cases DSBC in ERCP in our hospital from January 2013 to January 2019, according to the intubation tube method, we divided all the cases into 3 groups, single guide wire technique group (SGT)、DGT group and TPS group.Then compare the operation time of standard cannulation;the intubation success rate and the incidence of complications among the 3 groups. Results The operation time of standard cannulation in the DGT and TPS groups was(6.47±1.84) min and(5.29±2.01)min, respectively, which had significanlly difference from that in the SGT group (8.17±2.34) min( P <0.05). The success rate of Group DGT and TPS was 84.45% and 93.75%, respectively, which was statistically different from SGT group (76.09%, P <0.05). Postoperative complications: The overall complication rate was 12.07% in the DGT group and 20.83% in the TPS group.The overall complication rate of SGT group was 30.43%, and the difference between DGT, TPS and SGT group was significanlly difference ( P <0.05). Conclusion When DSBC and guide wire thread into the pancreatic duct, continue to single guide wire have low intubation success rate and higher incidence of complications,DGT and TPS can effectively improve the success rate of intubation, and complication rates are relatively low.
作者
唐尚军
白梅
王于梅
罗涛
邢明珍
谭向红
邓芳
余灏东
TANG Shang-jun;Bai Mei;WANG Yu-mei(Department of Gastroenterology,Qianjiang Central Hospital,Chongqing 409000,China)
出处
《吉林医学》
CAS
2019年第10期2207-2210,共4页
Jilin Medical Journal
基金
重庆市卫生计生委医学科研项目[项目编号:2017MSXM140]
关键词
经内镜逆行性胰胆管造影术
困难性胆管插管
双导丝技术
经胰管乳头括约肌切开术
并发症
Endoscopic retrograde cholangiopancreatography(ERCP)
Difficult selective biliary cannulation (DSBC)
Double-guidewire technique(DGT)
Trans-pancreatic sphincterotomy(TPS)
Complication rates
