摘要目的 探讨内镜下逆行胆囊管超选技术及胆囊塑料支架置入术治疗胆囊疾病的有效性和安全性.方法 以2010年1月至2016年6月在东方肝胆外科医院行内镜下逆行胆囊管超选技术及胆囊塑料支架置入术的患者为研究对象,回顾性分析胆囊管超选时间与胆囊置管时间,观察患者术后症状及并发症发生情况.结果 共入组10例患者,其中急性胆囊炎组2例、经皮经肝胆囊穿刺引流术(PTGBD)组4例、胆囊结石合并胆总管结石组4例.内镜下逆行胆囊管超选及胆囊塑料支架置入术成功率为100％,术后症状均缓解、PTGBD管均顺利拔除.10例患者平均胆囊管超选时间和胆囊置管时间分别为(10,2±6.9)min和(17.0±8.0)min.急性胆囊炎组、PTGBD组、胆囊结石合并胆总管结石组胆囊管超选时间分别为(18.5±4.9) min、(13.0±3.6) min与(3.3±1.3)min(F=18.86,P=0.002);胆囊置管时间分别为(25.5±4.9)min、(21.0±4.7)min与(8.8±1.0) min(F=18.04,P=0.002).术后并发急性胆管炎1例,经抗炎治疗后缓解,高淀粉酶血症1例,无急性胰腺炎、出血、穿孔等并发症发生,无操作相关死亡发生.结论 内镜下逆行胆囊管超选及胆囊塑料支架置入术是安全可行的,在特定胆囊疾病或胆囊合并胆管疾病的治疗中起到重要作用.

abstractsObjective To evaluate the technical feasibility and safety of endoscopic retrograde catheterization of gallbladder (ERCG) and endoscopic transpapillary gallbladder stenting (ETGS) for gallbladder diseases.Methods Patients who underwent ERCG and ETGS in Eastern Hepatobiliary Hospital from January 2010 to June 2016 were enrolled to this retrospective study.The superselection time of cystic duct,the catheterization time of gallbladder,postoperative symptoms and complications were analyzed.Results A total of 10 patients were enrolled to this study,including 2 cases of acute calculous cholecystitis,4 cases of percutaneous transhepatic gallbladder drainage (PTGBD) and 4 cases of cholecystocholedocholithiasis.The success rates of ERCG and ETGS were 100％.Symptoms were relieved in all patients and PTGBD catheter was removed after ETGS.The mean times of ERCG and ETGS were 10.2 ± 6.9 min and 17.0 ± 8.0 min respectively.The mean times of ERCG were 18.5±4.9 min,13.0±3.6 min and 3.3± 1.3 min,respectively (F=18.86,P =0.002).The mean times of ETGS were 25.5±4.9 min,21.0± 4.7 min and 8.8 ± 1.0 min,respectively (F =18.04,P =0.002).Complications included 1 case of cholangitis and 1 case of hyperamylasemia.Cholangitis was relieved after anti-inflammatory treatment.No acute pancreatitis,bleeding,perforation or procedure-related death occurred.Conclusion ERCG and ETGS are safe and feasible,which can play important roles in the treatment of specific gallbladder diseases or gallbladder with bile duct diseases.