内镜下逆行胰胆管造影术后并发十二指肠穿孔14例分析

• 作 者: 薛平 卢海武 胡以则
• 机 构: 广州医学院第二附属医院普外科,广州医学院第二附属医院普外科,广州医学院第二附属医院普外科 510260,510260,510260
• 出 处: 中国实用外科杂志
• 发表日期: 2004年05期
• 关键词: 内镜下逆行胰胆管造影 十二指肠穿孔

目的　探讨内镜下逆行胰胆管造影 (ERCP)术后并发十二指肠穿孔的诊治方法。方法　对 1996～2 0 0 3年ERCP术后并发十二指肠穿孔的 14例病人的诊治情况作回顾性分析。结果　 8例行非手术治疗 ,其中 5例痊愈 ;3例中转手术治疗 ,2例痊愈 ,1例死亡。另 6例急诊手术 ,术式有穿孔修补、胆总管T管引流术、腹腔清创、腹腔引流、经胃窦十二指肠造瘘、空肠造瘘术 ,其中 5例痊愈 ,1例死亡。结论　ERCP术后并发十二指肠穿孔具有特征性的临床表现及放射影像学征象 ,可作为决定手术与非手术治疗选择的重要指标 ,治疗方式必须根据各病例的特点选择。

Objective To investigate the diagnosis and treatment of duodenal perforation after endoscopic retrograde cholangiopancreatography (ERCP). Methods The clinical data of 14 patients with duodenal perforation after ERCP from 1996 to 2003 were analyzed retrospectively. Results Eight patients underwent non-surgical treatment, of which 5 were cured, 3 were treated by transit surgery, 2 recovered and 1 died. Another 6 cases of emergency surgery, surgical perforation repair, common bile duct T tube drainage, abdominal debridement, abdominal drainage, duodenum by gastric anastomosis, jejunostomy, of which 5 were cured and 1 died. Conclusions The clinical manifestations and radiological signs of duodenal perforation after ERCP can be used as an important index to decide the choice of surgical treatment and non-surgical treatment. The treatment method must be selected according to the characteristics of each case.