摘要
目的 探讨双导丝技术联合胰管支架对胆总管结石经内镜逆行胰胆管造影术(ERCP)术后胰腺炎(PEP)及高胰酶血症的影响。方法 按随机数表法将2021年1月至2022年12月于我院治疗的122例胆总管结石患者分为两组,每组61例。两组均行ERCP治疗,对照组采用传统胆管选择性插管治疗,观察组采用双导丝技术联合胰管支架治疗。比较两组插管成功率、围术期指标及并发症。结果 观察组插管成功率(95.08%,58/61)高于对照组(81.97%,50/61),观察组插管时间为(5.96±2.13)min,住院时间为(5.23±1.87)d,均短于对照组的(7.42±2.55)min、(6.17±2.40)d;观察组PEP发生率(1.64%,1/61)均低于对照组(13.11%,8/61),差异有统计学意义(P<0.05)。两组手术及进食时间、出血、胆道感染及高胰酶血症、十二指肠穿孔发生率比较,差异无统计学意义(P>0.05)。结论 胆总管结石ERCP术中联合采用双导丝技术与胰管支架,能够提高插管成功率,减少PEP的发生,缩短插管时间及住院时间,为胆总管结石ERCP的治疗提供指导。
Objective To investigate the effect of double guide wire technique combined with pancreatic duct stent on pancreatitis(PEP) and hyperpancreatemia after endoscopic retrograde cholangiopancreatography(ERCP) for choledocholithiasis.Methods A total of 122 patients with choledocholithiasis treated in our hospital from January 2021 to December 2022 were divided into two groups with 61 cases in each group according to random number table method.The two groups were treated with ERCP,the control group was treated with traditional selective biliary duct intubation,and the observation group was treated with double guide wire technique combined with pancreatic duct stent.The success rate of intubation,perioperative indexes and complications were compared between the two groups.Results The success rate of intubation in the observation group(95.08%,58/61) was higher than that in the control group(81.97%,50/61).The intubation time and hospitalization time in the observation group were(5.96±2.13) min and(5.23±1.87) d,both of which were shorter than those in the control group(7.42±2.55) min and(6.17±2.40) d.The incidence of PEP in observation group(1.64%,1/61) was lower than that in control group(13.11%,8/61),and the difference was statistically significant(P<0.05).There were no significant differences in the incidence of operation and feeding time,bleeding,biliary tract infection,hyperpancreatemia and duodenal perforation between the two groups(P>0.05).Conclusion The combined application of double guide wire technique and pancreatic duct stent during choledocholithiasis ERCP surgery can improve the success rate of intubation,reduce the occurrence of PEP,shorten the intubation time and hospital stay,and provide guidance for the treatment of choledocholithiasis ERCP.
作者
翟良蕊
葛大赫
许春进
ZHAI Liangrui;GE Dahe;XU Chunjin(Department of Gastroenterology,The First People's Hospital of Shangqiu,Shangqiu 476000 China)
出处
《内蒙古医学杂志》
2023年第9期1055-1058,共4页
Inner Mongolia Medical Journal
关键词
胆总管结石
内镜逆行胰胆管造影术
胰腺炎
高胰酶血症
choledocholithiasis
retrograde endoscopic cholangiopancreatography
pancreatitis
hyperpancre-atemia
