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目的探讨经内镜逆行胰胆管造影术(ERCP)在诊断和治疗儿童胰胆管疾病中的有效性和安全性。方法回顾分析2004年6月—2010年6月之间在杭州市第一人民医院进行ERCP术的32例患儿临床资料,其中男11例,女21例;≤12岁24例,>12岁8例,平均年龄11.8岁;术前诊断为胆总管阻塞性疾病20例,慢性胰腺炎12例;≤12岁患儿需要在全身麻醉下行ERCP术。结果 32例患儿共进行了34次ERCP,其中31例进行1次ERCP,1例乳头狭窄患儿进行了3次内镜下支架植入术。十二指肠乳头插管成功率为96.9%(31/32)。并发症的发生率为9.4%(3/32),其中1例为急性胰腺炎,2例为高淀粉酶血症,经保守治疗后均好转。没有发生重症胰腺炎、穿孔、出血或感染等严重并发症。对29例(90.6%)患儿进行了随访,随访时间2~6年不等,平均3.6年,无不良后果发生。结论 ERCP作为儿童胰胆管疾病的诊断和治疗工具,其并发症的发生率与成人相似。在麻醉方式上,年龄越小的儿童更需要全身麻醉。在训练有素的内镜医师操作下,ERCP在诊治儿童胰胆管疾病中的应用是有效和安全的。
Objective To investigate the efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis and treatment of pancreaticobiliary diseases in children. Methods The clinical data of 32 children undergoing ERCP from June 2004 to June 2010 were retrospectively analyzed, including 11 males and 21 females, 24 children aged ≤12 years and> 12 years old 8 cases, the average age of 11.8 years; preoperative diagnosis of common bile duct obstruction in 20 cases, 12 cases of chronic pancreatitis; ≤ 12-year-old children undergoing ERCP under general anesthesia. RESULTS: Thirty-two ERCPs were performed in 32 patients, including 31 ERCPs and 1 papillary stenosis underwent endoscopic stenting. Duodenal papilla intubation success rate was 96.9% (31/32). The incidence of complications was 9.4% (3/32), of which 1 was acute pancreatitis and 2 was hypermylasemic, which improved after conservative treatment. No serious complications such as severe pancreatitis, perforation, bleeding or infection occurred. Twenty-nine patients (90.6%) were followed up for 2-6 years with an average of 3.6 years without any adverse consequences. Conclusion As a diagnostic and therapeutic tool for children with pancreaticobiliary duct disease, the incidence of complications is similar to that of adults. In anesthesia, the younger children need general anesthesia. The application of ERCP in the diagnosis and treatment of pancreaticobiliary duct disease in children is effective and safe under the well-trained endoscopist.