超声内镜引导下对接技术治疗经内镜逆行胰胆管造影术失败的恶性梗阻性黄疸的疗效研究*

EUS-guided rendezvous for malignant obstructive jaundice after failured ERCP*

摘要:

目的??探讨超声内镜引导下对接技术（EUS-RV）治疗经内镜逆行胰胆管造影术（ERCP）失败的恶性梗阻性黄疸的疗效。方法?12例恶性梗阻性黄疸患者在ERCP不成功后改为EUS-RV治疗。观察其操作成功率、术后1周及1个月肝功能指标恢复情况、并发症发生率、住院时间及患者生存期。结果?12例患者均通过超声内镜穿刺成功，经胃穿刺者8例，经十二指肠穿刺4例，成功率为100.00%；术后1周较术前、术后1个月较术后1周肝功能指标差异有统计学意义（P <0.05）；并发出血1例，经保守治疗后改善，并发症发生率8.33%；所有患者住院时间为（20.68±5.76） d；平均生存期为224 d。结论?EUS-RV创伤小、疗效好，可作为ERCP失败的恶性梗阻性黄疸患者的替代治疗。

Abstract:

Objective?To study the therapeutic effect of EUS-guided rendezvous (EUS-RV) when ERCP failed in patients with malignant obstructive jaundice.?Methods?12 cases of malignant obstructive jaundice patients were underwent EUS-RV after unsuccessful ERCP. The operation success rate, liver function recovery 1 week and 1 month after operation, complication rates, hospital stay and patient survival were observed.?Results?All 12 patients were successfully operated and placed stents by endoscopic ultrasound puncture following by ERCP: 8 patients by the stomach, 4 patients by duodenum, the operation success rate was 100.00%; There were significant difference between the liver function recovery of preoperative and postoperative one week or postoperative one week and postoperative one month (P < 0.05). 1 bleeding occurred and were improved after conservative treatment, the complications rate was 8.33%; the hospital stay was (20.68 ± 5.76) d; the average survival time of patients was 224 d.?Conclusion?EUS-guided rendezvous may be the alternative treatment due to the diminutive trauma and good effect when ERCP failed in patients with malignant obstructive jaundice.