论文部分内容阅读
本文对64例壶腹周围癌病人施行内窥镜逆行胰胆管造影术(ERCP)结果作分析,其中49铡插管造影成功,15例在插管失败后经活检或手术证实壶腹周围癌存在。造影成功的49例中有11例在常规插管失败后改用导丝强行造瘘,再推入导管使造影成功。7例在乳头切开后再用导丝穿过狭窄区,使造影成功。7例在乳头切开后做了深部活检。作者认为壶腹周围癌早期症状不明显,尤合并其它胆胰良性病变时更易误诊,故应力争早做 ERCP。导丝造瘘或乳头切开后再造瘘能提高造影的成功率。乳头切开后做深部活检能提高癌的检出率。
This article analyzes the results of endoscopic retrograde cholangiopancreatography (ERCP) in 64 patients with periampullary carcinoma. Among them, 49 angiograms have been successfully performed. 15 cases have been confirmed by biopsy or surgery after the failure of intubation. . Among the 49 cases with successful angiography, 11 cases had failed to use the guide wire to forcibly make fistula after the failure of the conventional intubation, and then pushed into the catheter to make the angiography successful. In 7 cases, the guide wire was passed through the stenosis area after the papillary incision. Seven patients underwent deep biopsy after the nipple was cut. The authors believe that the early symptoms of periampullary cancer are not obvious, especially when combined with other benign pancreatic and benign lesions, they are more likely to be misdiagnosed, so it is important to strive to do early ERCP. The success rate of angiography can be improved by using a guide wire for ostomy or after nipple incision. Deep biopsy after incision of the nipple can increase the detection rate of cancer.