Abstract:

Value of ERCP in the treatment of iatrogenic bile duct injury        ZHOU Wen-ce, ZHANG Hui, LI Xun. No.2 Department of General Surgery, the First Hospital of Lanzhou University; Center of ERCP Diagnosis and Treatment, the First Hospital of Lanzhou University; Research Institute of Hepatobiliary and Pancreatic Surgery of Gansu Province; Key Laboratory of Cell Therapy and Regenerative Medicine of Gansu Province, Lanzhou 730000, China
Corresponding author: ZHOU Wen-ce, E-mail: zhouwc@lzu.edu.cn
Abstract    It happens clinically that bile duct injury may be the result of biliary operations, of which laparoscopic cholecystectomy, liver transplantation and biliary reconstruction are the most common. There are mainly two pathological types of bile duct injury, namely bile leakage and stenosis of bile duct, and sometimes they exist in combination. The clinical treatment of bile duct injury is difficult for doctors, and whether the treatment is given in a proper timing and proper way could affect the prognosis of bile duct injury patients. Therefore, bile duct injury should be treated individually. Endoscopic retrograde cholangiopancreatography (ERCP), due to its advantages of being minimally invasive, well effective, and repeatable, has become the initial and preferred therapeutic schemes in treating bile duct injury. However, most patients need to be treated repeatedly to achieve an ideal effect. For some patients not receiving good curative effect, ERCP can help to further clarify the degree of injury, and create favorable conditions for further deterministic surgical treatment.

Key words: endoscopic retrograde cholangiopancreatography, bile duct injury, bile leakage, stenosis of bile duct

摘要：

胆道损伤多由各种胆道手术所致，临床上时有发生。最常见原因是腹腔镜胆囊切除术，肝移植术及胆道重建术后等。胆道损伤包括胆漏型胆道损伤及狭窄型胆道损伤，有时合并存在。胆道损伤临床治疗棘手，治疗的时机及恰当的治疗手段是治疗胆道损伤的关键所在。不同类型的胆道损伤需采取个体化的治疗方案。内镜逆行胰胆管造影（ERCP）以其微创、疗效佳、可反复进行等优势在胆道损伤的治疗中已成为主要的治疗措施之一，但多数病人需反复多次ERCP方能取得较理想的治疗效果。对于部分疗效不佳的病人，ERCP可进一步明确损伤程度，为进一步确定性外科治疗创造有利条件。

关键词: 内镜逆行胰胆管造影, 胆道损伤, 胆漏, 胆道狭窄