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对64例经ERCP及B超证实的梗阻性黄疸患者分别进行了乳头括约肌切开,网篮取石,胆总管内机械碎石,胆管气囊扩张,鼻胆引流及胆总管支架管引流.结果:①51例成功地进行了ERCP治疗,成功率为79.7%.②治疗后2周内胆总管直径较治疗前明显缩小(P<0.05);血清总胆红素、ALT及γ-GT较治疗前明显下降(P<0.05～0.01).③胆总管结石患者治疗后1周内腹痛缓解率为92.1%;退热率为100%.④并发症的发生率为7.8%,主要是乳头切开处出血、急性胰腺炎及结石嵌顿,经适当处理很快好转恢复.结果表明:梗阻性黄疸患者ERCP治疗具有患者损伤轻,痛苦小,耐受好及恢复快等优点,应作为单纯胆总管结石,特别是伴有胆囊或股道手术后及高龄患者的首选治疗方法.
Sixty-four patients with obstructive jaundice confirmed by ERCP and B ultrasound were respectively treated with sphincterotomy, basket removal, mechanical gravel in common bile duct, dilatation of bile duct, drainage of biliary duct and drainage of common bile duct stent.Results: The success rate of ERCP was 79.7% .②The diameter of the common bile duct was significantly reduced 2 weeks after treatment (P <0.05); the levels of total bilirubin, ALT and γ-GT were significantly lower than those before treatment (P <0.05 ~ 0.01) .③The rate of abdominal pain relief was 92.1% within one week after treatment in patients with common bile duct stones and the rate of fever was 100% .④ The incidence of complications was 7.8%, mainly bleeding at the incision of the nipple, Acute pancreatitis and stone incarceration, the appropriate treatment quickly improved recovery.The results showed that: patients with obstructive jaundice ERCP has the advantages of light injury, little pain, good tolerance and rapid recovery, should be used as a simple common bile duct stones, especially Is accompanied by gallbladder or femoral surgery and elderly patients preferred treatment.