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【摘要】目的探讨内镜逆行胰胆管造影术（ERCP）相关罕见出血的原因及治疗方案。方法对行ERCP联合十二指肠乳头切开术（EST）患者的临床资料进行回顾性分析。结果1 423例患者，ERCP+EST治疗中即刻出血44例，延迟出血1例，出血发生率为3.16%（45/1 423）。出血直接原因： 42例为EST切口出血，3例罕见出血原因分别为憩室出血、胆管壁损伤出血、胆管壁血管瘤出血。结论ERCP术中一旦发生出血，内镜下止血是有效且安全的，若内镜治疗失败，可行十二指肠动脉栓塞疗法或外科手术治疗。
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临床研究
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更新时间：2017-08-23
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内镜逆行胰胆管造影术相关罕见出血的治疗策略▲
Treatment strategy of rare hemorrhage related to endoscopic retrograde cholangiopancreatography
微创医学 201712卷04期 页码：486-488
作者机构：（广西壮族自治区人民医院消化内科，南宁市530021）
基金信息：▲基金项目：广西壮族自治区卫生厅科研课题（编号：Z2012294） *通信作者
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【Abstract】 ObjectiveTo explore the causes and therapeutic regimen for rare hemorrhage related to endoscopic retrograde cholangiopancreatography(ERCP). MethodsThe clinical data of patients undergoing ERCP and endoscopic sphincterotomy (EST) were retrospectively analyzed. ResultsA total of 1423 patients enrolled, hemorrhage during ERCP+EST and delayed hemorrhage occurred in 44 cases and 1 case respectively. The incident rate of hemorrhage was 3.16%（45/1 423）. The exciting cause for hemorrhage in 42 cases was EST incision hemorrhage . The causes for rare hemorrhage in three cases were hemorrhage of diverticulum，injury of bile duct wall and angeioma of bile duct wall separately. ConclusionEndoscopic hemostasis is safe and effective when hemorrhage occurs during ERCP. Duodenal artery embolization or surgery can be performed if endoscopic treatment fails.
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