中国实用外科杂志

中国实用外科杂志 ›› 2010, Vol. 30 ›› Issue (05): 337-339.

• 专题笔谈 • 上一篇    下一篇

ERCP在胆胰结合部疾病中的应用

秦鸣放   

  1. 天津市南开医院微创外科，天津300100
  • 出版日期:2010-05-01 发布日期:2010-05-06

  • Online:2010-05-01 Published:2010-05-06

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摘要：

随着十二指肠镜设备和器械发展，内镜逆行胰胆管造影（ERCP）在胆胰管结合部疾病治疗中占有非常重要地位。ERCP治疗的胆胰管结合部疾病主要包括结石、肿瘤、Oddi括约肌狭窄和胆胰管合流异常。胆胰管结合部结石嵌顿通过括约肌切开术（EST）或电针开窗可迅速缓解； 无法根治性切除的恶性肿瘤可行内镜胆管引流术（ERBD）或内镜胆管金属支架术（EMBE）建立胆汁内引流，严重黄疸术前利用鼻胆导管引流术（ENBD）可有效减黄；Oddi括约肌狭窄行EST优势明显，已经代替传统开腹括约肌成型术；治疗无胆总管扩张的胰胆管合流异常现处于探索阶段。

关键词: 内镜逆行胰胆管造影, 胆胰结合部

Abstract:

Roles of ERCP in the treatment of disorders at pancreaticobiliary junction        QIN Ming-fang. Department of Minimally Invasive Surgery，Tianjin Nankai Hospital，Tianjin 300100, China
Abstract    With the development and evolution of duodenum endoscopy devices and instruments, endoscopic retrograde cholangiopancreatography (ERCP) has been playing more and more important roles in the treatment of disorders at pancreaticobiliary junction, which includes: benign bile stones, Oddi’s sphincter stenosis, anomalous pancreaticobiliary junction and malignant lesions. The topics are discussed in detail with hand-on experience of the author in the article. The impacted bile stones at the pancreaticobiliary junction can be evacuated by endoscopic sphincterotomy (EST). Surgically incurable malignant lesions can be intraluminally drained by endoscopic retrograde biliary drainage (ERBD) or expandable metallic biliary endoprothesis (EMBE). Severe jaundice can be relieved by endoscopic nasobiliary drainage (ENBD). Oddi’s sphincter stenosis is effectively managed by EST. In addition, the treatment of anomalous pancreaticobiliary junction without dilated common bile duct is still under investigation.

Key words: endoscopic retrograde cholangiopancreatography, pancreaticobiliary junction