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目的:探讨胰管塑料支架在内镜逆行性胰胆管造影术(ERCP)选择性胆管插管困难时的应用。方法:选择佛山市第一人民医院2012年1月至2015年12月42例因在ERCP术中选择性胆管插管困难的患者临床资料进行回顾性分析。患者均采用弓状刀行乳头切开术,并置入胰管塑料支架,观察是否术后并发胰腺炎或其他并发症。结果:接受ERCP的42例患者中,5例出现高淀粉酶血症,2例出现术后胰腺炎;患者术后腹痛评分为:2分;术后Ranson评分均为轻症。术后72 h血淀粉酶降至正常。术后3~4周,均于门诊电子胃镜下圈套器取出胰管支架,仅2例患者胰管支架外移约1 cm,所有支架,均未见堵塞。结论:ERCP选择性胆管插管困难的患者放置胰管支架可以预防胰腺炎的发生。
Objective: To investigate the application of pancreatic duct plastic stent in cholecystectomy for endoscopic retrograde cholangiopancreatography (ERCP). Methods: A retrospective analysis was performed on the clinical data of 42 patients with difficult choledocholithiasis during ERCP from January 2012 to December 2015 in Foshan First People’s Hospital. Patients were treated with arcuate knife nipple incision, and placed in plastic stent in the pancreas to observe whether postoperative complications of pancreatitis or other complications. Results: Of the 42 patients who received ERCP, 5 had hyper amylase and 2 had postoperative pancreatitis. The postoperative abdominal pain score was 2 and the postoperative Ranson score was mild. Blood amylase decreased to normal 72 hours after operation. Three to four weeks postoperatively, pancreatic duct stents were removed in the outpatient electronic gastroscope under the gastroposcope. Only two patients had a pancreatic duct stent shift of about 1 cm. No stent was found in all the stents. Conclusion: Placement of pancreatic duct stents in patients with ERCP-selective cholangiocarcinoma can prevent the occurrence of pancreatitis.