Indication Selections of ERCP in Current Medical Condition_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

SUO Guangjun , XU An , HU Hai.

Department of Minimally Invasive Surgery, Affiliated Dongfang Hospital of Tongji University, Shanghai 200120, China;

Corresponding author：

Keywords：

Endoscopic retrograde cholangiopancreatography; Laproscopy; Common bile duct stone; Laparoscopic exploration of the common bile duct

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ObjectiveTo explore how to select the suitable indications of ERCP for clinical diagnosis and treatment. MethodsThe data of patients treated by ERCP between January 2005 and December 2009 in our hospital were analyzed retrospectively. ResultsTotal 221 patients received ERCP, among whom 99 (45%) cases of common bile duct stones, 44 (20%) cases of malignant tumor, 9 (4%) cases of papilla narrow, 45 (20%) cases were negative, and 24 (11%) cases were failed. It had the trend that the number of the patients received ERCP reduced year by year. The postoperative complication rate was 11% (25 cases), including 15 cases of postoperative pancreatitis, 3 cases of bleeding, 5 cases of biliary duct infection, and 2 cases of basket stranded. ConclusionIn the modern medical condition, with the advancement of image and laparoscopy technology, we should select the diagnosis and treatment methods with the principles of no damage or less damage for patients, without unlimitedly broadening the clinical indications of ERCP.

Citation： SUO Guangjun,XU An,HU Hai.. Indication Selections of ERCP in Current Medical Condition. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(5): 533-536. doi: Copy

1.	Patel AP, Lokey JS, Harris JB, et al. Current management of common bile duct stones in a teaching community hospital [J]. Am Surg, 2003, 69(7): 555560.
2.	Fogel EL, Sherman S, Park SH, et al. Therapeutic biliary endoscopy [J]. Endoscopy, 2003, 35(2): 156163.
3.	Sharma M, Babu CS, Dhiman RK, et al. Induced hypotension in the management of acute hemobilia during therapeutic ERCP in a patient with portal biliopathy (with videos) [J]. Gastrointest Endosc, 2010, 72(6): 13171319.
4.	王健, 杜波, 胡兵. EST 后近期严重并发症及其危险因素分析 [J]. 中国普外基础与临床杂志, 2010， 17(5): 486489.
5.	蔡阳, 朱玮, 封光华, 等. EST 严重并发症的外科治疗 [J]. 中华肝胆外科杂志, 2005， 11(9): 616617.
6.	田大广, 黄洁，张捷，等. LC与EST联合应用治疗胆囊结石继发性胆总管结石 [J]. 中国普通外科杂志, 2006， 15(8): 579581.
7.	Freeman ML, Nelson DB, Sherman S, et al. Complications of endoscopic biliary sphincterotomy [J]. N Engl J Med, 1996, 335(13): 909918.
8.	Cheng CL, Sherman S, Watkins JL, et al. Risk factors for postERCP pancreatitis: a prospective multicenter study [J]. Am J Gastroenterol, 2006, 101(1): 139147.
9.	Poon RT, Liu CL, Lo CM, et al. Management of gallstone cholangitis in the era of laparoscopic cholecystectomy [J]. Arch Surg, 2001, 136(1): 1116.
10.	Paganini AM, Lezoche E. Followup of 161 unselected consecutive patients treated laparoscopically for common bile duct stones [J]. Surg Endosc, 1998, 12(1): 2329.
11.	Memon MA, Hassaballa H, Memon MI.Laparoscopic common bile duct exploration: the past, the present, and the future [J]. Am J Surg, 2000, 179(4): 309315.
12.	殷泙, 马恩伟, 包文敏. 胃大部切除毕Ⅱ式吻合术后胆管疾病的侧视内镜下治疗 [J]. 中华肝胆外科杂志, 2005， 11(9): 609611.
13.	汪强武, 燕善军, 刘会春. 胰、胆管梗阻病变中脱落细胞端粒酶活性的测定 [J]. 中华全科医学, 2008, 6(11): 11231124.
14.	王洛伟, 李兆申, 许国铭, 等. 胰管刷检标本细胞学联合VEGF 检测对胰腺癌的诊断价值 [J]. 胰腺病学, 2003, 3(1): 3336.
15.	孙晓梅, 任旭, 唐秀芬. 胰腺癌影像学所见与肿瘤大小及分期关系的研究 [J]. 中华消化内镜杂志, 2006, 23(3): 186188.
16.	林金水, 马小敏, 李传旺, 等. ERCP、MRI、螺旋CT 对胰胆管疾病诊断分析 [J]. 基层医学论坛, 2006, 10(1): 4243.
17.	Sahni VA, Mortele KJ. Magnetic resonance cholangiopancreatography: current use and future applications [J]. Clin Gastroenterol Hepatol, 2008, 6(9): 967977.
18.	李祥兵, 贾国法, 朱良松, 等. 70岁以上老年患者治疗性ERCP安全性探讨 [J]. 胃肠病学和肝病学杂志, 2010, 19(4): 374377.
19.	王雪峰, 李济宇, 张文杰. 手术和内窥镜治疗高龄急性化脓性胆管炎的比较 [J]. 上海第二医科大学学报, 2003, 23(1): 6566.
20.	李兵，龚昭，李红, 等. 内镜介入治疗急性化脓性胆管炎31例分析 [J]. 中国内镜杂志, 2008, 14(11): 11741176.
21.	金安琴, 黄晓俊,王伟，等. 早期内镜治疗急性胆源性胰腺炎46例临床研究 [J]. 中国普外基础与临床杂志, 2010, 17(10): 10011005.
22.	姚欣敏, 李云涛, 黄德全, 等. 多种微创方法联合个体化治疗重症急性胰腺炎 [J] . 中国普外基础与临床杂志, 2010, 17(6): 586590.
23.	Lawrence C, Howell DA, Conklin DE, et al. Delayed pancreaticoduodenectomy for cancer patients with prior ERCPplaced, nonforeshortening, selfexpanding metal stents: a positive outcome [J]. Gastrointest Endosc, 2006, 63(6): 804807.
24.	蔡云峰, 苏树英, 费凛, 等. Ⅳ型肝门部胆管癌单侧塑料内支架置入治疗的前瞻性研究 [J]. 中国普通外科杂志, 2010, 19(2): 180183.
25.	Somogyi L, Chuttani R, Croffie J, et al. Biliary and pancreatic stents [J]. Gastrointest Endosc, 2006, 63(7): 910919.
26.	Clayton ES, Connor S, Alexakis N, et al. Metaanalysis of endoscopy and surgery versus surgery alone for common bile duct stones with the gallbladder in situ [J]. Br J Surg, 2006, 93(10): 11851191.

1. Patel AP, Lokey JS, Harris JB, et al. Current management of common bile duct stones in a teaching community hospital [J]. Am Surg, 2003, 69(7): 555560.
2. Fogel EL, Sherman S, Park SH, et al. Therapeutic biliary endoscopy [J]. Endoscopy, 2003, 35(2): 156163.
3. Sharma M, Babu CS, Dhiman RK, et al. Induced hypotension in the management of acute hemobilia during therapeutic ERCP in a patient with portal biliopathy (with videos) [J]. Gastrointest Endosc, 2010, 72(6): 13171319.
4. 王健, 杜波, 胡兵. EST 后近期严重并发症及其危险因素分析 [J]. 中国普外基础与临床杂志, 2010， 17(5): 486489.
5. 蔡阳, 朱玮, 封光华, 等. EST 严重并发症的外科治疗 [J]. 中华肝胆外科杂志, 2005， 11(9): 616617.
6. 田大广, 黄洁，张捷，等. LC与EST联合应用治疗胆囊结石继发性胆总管结石 [J]. 中国普通外科杂志, 2006， 15(8): 579581.
7. Freeman ML, Nelson DB, Sherman S, et al. Complications of endoscopic biliary sphincterotomy [J]. N Engl J Med, 1996, 335(13): 909918.
8. Cheng CL, Sherman S, Watkins JL, et al. Risk factors for postERCP pancreatitis: a prospective multicenter study [J]. Am J Gastroenterol, 2006, 101(1): 139147.
9. Poon RT, Liu CL, Lo CM, et al. Management of gallstone cholangitis in the era of laparoscopic cholecystectomy [J]. Arch Surg, 2001, 136(1): 1116.
10. Paganini AM, Lezoche E. Followup of 161 unselected consecutive patients treated laparoscopically for common bile duct stones [J]. Surg Endosc, 1998, 12(1): 2329.
11. Memon MA, Hassaballa H, Memon MI.Laparoscopic common bile duct exploration: the past, the present, and the future [J]. Am J Surg, 2000, 179(4): 309315.
12. 殷泙, 马恩伟, 包文敏. 胃大部切除毕Ⅱ式吻合术后胆管疾病的侧视内镜下治疗 [J]. 中华肝胆外科杂志, 2005， 11(9): 609611.
13. 汪强武, 燕善军, 刘会春. 胰、胆管梗阻病变中脱落细胞端粒酶活性的测定 [J]. 中华全科医学, 2008, 6(11): 11231124.
14. 王洛伟, 李兆申, 许国铭, 等. 胰管刷检标本细胞学联合VEGF 检测对胰腺癌的诊断价值 [J]. 胰腺病学, 2003, 3(1): 3336.
15. 孙晓梅, 任旭, 唐秀芬. 胰腺癌影像学所见与肿瘤大小及分期关系的研究 [J]. 中华消化内镜杂志, 2006, 23(3): 186188.
16. 林金水, 马小敏, 李传旺, 等. ERCP、MRI、螺旋CT 对胰胆管疾病诊断分析 [J]. 基层医学论坛, 2006, 10(1): 4243.
17. Sahni VA, Mortele KJ. Magnetic resonance cholangiopancreatography: current use and future applications [J]. Clin Gastroenterol Hepatol, 2008, 6(9): 967977.
18. 李祥兵, 贾国法, 朱良松, 等. 70岁以上老年患者治疗性ERCP安全性探讨 [J]. 胃肠病学和肝病学杂志, 2010, 19(4): 374377.
19. 王雪峰, 李济宇, 张文杰. 手术和内窥镜治疗高龄急性化脓性胆管炎的比较 [J]. 上海第二医科大学学报, 2003, 23(1): 6566.
20. 李兵，龚昭，李红, 等. 内镜介入治疗急性化脓性胆管炎31例分析 [J]. 中国内镜杂志, 2008, 14(11): 11741176.
21. 金安琴, 黄晓俊,王伟，等. 早期内镜治疗急性胆源性胰腺炎46例临床研究 [J]. 中国普外基础与临床杂志, 2010, 17(10): 10011005.
22. 姚欣敏, 李云涛, 黄德全, 等. 多种微创方法联合个体化治疗重症急性胰腺炎 [J] . 中国普外基础与临床杂志, 2010, 17(6): 586590.
23. Lawrence C, Howell DA, Conklin DE, et al. Delayed pancreaticoduodenectomy for cancer patients with prior ERCPplaced, nonforeshortening, selfexpanding metal stents: a positive outcome [J]. Gastrointest Endosc, 2006, 63(6): 804807.
24. 蔡云峰, 苏树英, 费凛, 等. Ⅳ型肝门部胆管癌单侧塑料内支架置入治疗的前瞻性研究 [J]. 中国普通外科杂志, 2010, 19(2): 180183.
25. Somogyi L, Chuttani R, Croffie J, et al. Biliary and pancreatic stents [J]. Gastrointest Endosc, 2006, 63(7): 910919.
26. Clayton ES, Connor S, Alexakis N, et al. Metaanalysis of endoscopy and surgery versus surgery alone for common bile duct stones with the gallbladder in situ [J]. Br J Surg, 2006, 93(10): 11851191.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Indication Selections of ERCP in Current Medical Condition

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