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endoscopic needle-knife papillotomy
相关语句
  内镜下针形刀乳头括约肌切开术
    CLINICAL APPLICATION OF ENDOSCOPIC NEEDLE-KNIFE PAPILLOTOMY
    内镜下针形刀乳头括约肌切开术的临床应用
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Objective:To sum up the experience of endoscopic needle-knife papillotomy for the obstructive disease in duodenum peripapilla.Methods:Altogether 24 cases of the obstructive disease in duodenum peripapilla were treated by the endoscopic needle-knife papillotomy in our department from March 1999 to March 2001. Among them, there were 4 cases of pancreatic carcinoma, 1 case of ampullary carcinoma, 13 cases of impacted choledocholithiasis, 2 cases of impacted ascariasis, 3 cases of stricture of the Oddi's...

Objective:To sum up the experience of endoscopic needle-knife papillotomy for the obstructive disease in duodenum peripapilla.Methods:Altogether 24 cases of the obstructive disease in duodenum peripapilla were treated by the endoscopic needle-knife papillotomy in our department from March 1999 to March 2001. Among them, there were 4 cases of pancreatic carcinoma, 1 case of ampullary carcinoma, 13 cases of impacted choledocholithiasis, 2 cases of impacted ascariasis, 3 cases of stricture of the Oddi's sphincter and 1 case of the papilla distortion. It was often difficult to perform the bile duct cannulation with standard endoscopic technique for these obstructive diseases, using the technique of the needle-knife papillotomy at distal bile duct eminentia,it made possible to overcome problems of bile duct cannulation.Results:All the patients were successfully performed under the endoscopic needle-knife papillotomy and had good effect. They were treated with the sequential endoscopic precut papillotomy by the needle-knife and the therapeutic procedures, such as sphincterotomy, stone extraction using Dormia basket, extraction the parasites, placement of biliary stent or naso-biliary tube: There was no death and no perforation of the duodenum. Two patients bleeded during the needle-knife sphincterotomy, and staunched by the electrocoagulation and spraying the hemostatics. Conclusions:Endoscopic needle-knife papillotomy is an alternative technique when biliary cannulation fails using routine endoscopic procedure. And it can increase successful rate of the diagnosis and management of the especially in the ampullary impacted disease.

目的 :探讨在十二指肠乳头梗阻性病变的内镜处理。方法 :从 1 999年 3月~ 2 0 0 1年 3月 ,对于 2 4例病人 ,其中男性 1 5例 ,女性 9例 ,平均年龄 52岁。在临床上出现黄疸 ,化脓性胆管炎、胆道蛔虫症、胆囊切除术后综合症、所致的oddis括约肌开口处的梗阻性病变 ,包括胰头部肿瘤 4例 ,壶腹部肿瘤 1例 ,胆总管结石嵌顿1 3例 ,蛔虫嵌顿 2例 ,oddis括约肌严重狭窄 3例 ,十二指肠乳头扭曲 1例。这些病变在常规内镜诊断治疗时 ,乳头插管往往困难。利用针型切开刀 ,在十二指肠乳头开口处近端 ,即胆管隆起部作开窗并置管插入胆道 ,再进行一系列相应的内镜治疗。结果 :乳头开窗术在 2 4例病人中均获成功。经乳头开窗术置管作内镜治疗包括乳头括约肌切开 ,网篮取石 ,取蛔虫 ,置入胆道内置管、鼻胆管引流 ,均获得满意的效果。在乳头开窗时有 2例出现少量渗血 ,经电凝、喷洒止血药物后缓解。无十二指肠穿孔发生。结论 :对于常规十二指肠乳头插管困难时 ,利用针型切开刀可获得满意的效果 ,提高了内镜诊断治疗的成功率。特别对于乳头处的嵌顿病变 ,更可达到事半功倍的疗效。

 
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