和谐夹辅助在十二指肠憩室边缘乳头插管困难患者中的应用*

Hemostatic clips to facilitate intubation during ERCP with ampulla around duodenal diverticulum*

摘要:

观察和谐夹助在十二指肠憩室边缘乳头插管困难中应用的效果。方法 选取25例行经内镜逆行胰胆管造影（ERCP）的患者，为憩室边缘乳头，尝试插管困难（常规插管>10 min）。实验组11例使用和谐夹将乳头一侧黏膜夹闭，对照组14例继续尝试传统技术插管，记录两组插管成功例数及时间，比较两组术后并发腹痛、胰腺炎发生率。结果 实验组患者均插管成功（100.00%），对照组12例成功（85.7%）。实验组手术耗时少于对照组（P <0.05），术后并发症差异无统计学意义（P >0.05）。结论 合理地应用和谐夹，有利于十二指肠憩室边缘乳头暴露和成功插管。

关键词:

经内镜逆行胰胆管造影;十二指肠乳头旁憩室;插管困难;和谐夹

Abstract:

To investigate the effectiveness of hemostatic-clip-assisted method during ERCP with ampulla around duodenal diverticulum. Methods 25 patients with ampulla around duodenal diverticulum encountered cannulation difficulty, 11 cases underwent with clip-assisted method, 14 cases with ordinary ways. Number of successful cases, cannulation time, post-operation complication were analyzed. Results All the 11 cases succeeded in clip group. 12 patients succeeded in none-clip group. Cannulation time between the two groups were discrepant. There was no difference in number of successful cases and post-operation complication rate. Conclusion Successful application of hemostatic clip help to expose and facilitate cannulation of an ampulla around a duodenal diverticulum.

Key words:

endoscopic retrograde cholangiopancreatography; juxtapapillary duodenal diverticulum; intubation difficulty; hemostatic clip