摘要目的 探讨导丝引导技术在高位胆道梗阻内镜下选择性胆管插管中的应用价值.方法 对344例经ERCP诊治的高位胆道梗阻患者,乳头部胆管插管成功后应用导丝直通法、导管导丝法、乳头切开刀法、导管导丝+导丝弯曲法、导丝α及反α结袢法、导丝旋转法、导丝直通联合取石球囊法及多孔导向导管法等多种导丝引导方法进行选择性胆管深插管,使其通过胆管狭窄段,进入目标胆管.观察插管效果.结果 336例高位胆道梗阻患者顺利完成超选择性目标胆管插管,随后完成相应内镜下治疗,总成功率为97.67％.所有患者在插管过程中无合并胆道出血及穿孔等病例.结论 高位胆道梗阻内镜下选择性胆管插管中不同导丝引导方法可以提高微创诊疗成功率、缩短操作时间,减少患者痛苦、降低并发症的发生率.

abstractsObjective To explore the application value of the guide-wire for selective biliary cannulation of proximal biliary obstruction.Methods A total of 344 patients with proximal biliary obstruction were treated by endosocopic retrograde cholangio-pancreatography.Various guide-wire skills,were applied to pass through the stricture of bile duct,so as to reach the target bile duct,and analyzed for their therapeutic effects.Results Selective biliary cannulation of proximal biliary obstruction was completed in 336 patients,after successful cholangiography for therapeutic operation.The overall success rate was 97.67％.There was no procedure-related complications,such as hemobilia or perforation.Conclusion The guide-wire for selective biliary cannulation of proximal biliary obstruction not only improves the success rate of therapeutic endoscopy but also reduces the procedure time and the incidence of complications.