十二指肠隆起性病变的内镜治疗

Emioseopic treatmeut of duodenum elevated lesions

摘要:

目的??分析十二指肠隆起性病变内镜治疗的安全性及有效性。方法?对十二指肠隆起性病变患者内镜治疗的临床资料、内镜治疗方法、病理特点、并发症和随访情况进行回顾性分析。结果?112例患者中111例均行内镜治疗，1例中转外科治疗。其中行电凝灼烧术49例，圈套切除术+内镜下黏膜切除术（EMR）36例，内镜黏膜下剥离术（ESD）27例。并发症发生率16.96% （19/112），其中1例因术中大出血，止血困难，中转开腹治疗，7例术中活动性出血，予电热活检钳止血治疗，穿孔6例，迟发性出血2例，一过性淀粉酶升高2例，迟发性穿孔1例。术后随访1～12个月总有效率100.0%。结论?内镜治疗十二指肠隆起性病变，具有创伤小、恢复快、费用低和并发症少等优点，内镜治疗将在十二指肠肿瘤中发挥重要的作用。

Abstract:

Objective?To assess the curative effect and safety of endoscopic therapy at duodenum elevated lesions.?Methods?We retrospectively studied the clinical data including general data, the procedure of performance, the lesions pathological characters, complications and recurrence after the treatment of patients who underwent endoscopic treatment.?Results?111 patients of 112 patients were treated by endoscopic treatment successfully, 1 case was treated by surgery. 49 lesions were treated by electrocoagulation, 36 lesions were treated by polypectomy or endoscopic mucosal resection (EMR), 27 by endoscopic submucosal dissection (ESD). Complication rate was 16.96% (19/112), 1 case of active bleeding was treated by surgery in hemostasis difficulty. 6 cases of perforation, 2 cases of delayed bleeding, 2 cases of transient increase in amylase level and 1 case of delayed perforation. All the patients were successfully performed. Post-operation follow-up period was 1~12 months.?Conclusion?Endoscopic treatment holds advantages of minimally invasive, quick recovery, low cost, and less risk which may be play an important role in duodenal elevated lesions.