内镜逆行胰胆管造影术在胆囊癌合并恶性梗阻性黄疸中的临床应用价值

Clinical value of endoscopic retrograde cholangiopancreatography in gallbladder carcinoma with malignant obstructive jaundice

摘要:

目的 探究内镜逆行胰胆管造影术（ERCP）在胆囊癌合并恶性梗阻性黄疸中的临床应用价值。方法 回顾性分析2016年1月－2019年9月该院收治的20例胆囊癌合并恶性梗阻性黄疸患者的临床资料，比较ERCP治疗前后总胆红素（TBil）和直接胆红素（DBil）水平，以及病理组织情况。结果 ERCP治疗前后TBil［（230.61±100.73）和（110.10±55.02）μmol/L］和DBil［（190.93±99.72）和（88.13±38.30）μmol/L］比较，差异有统计学意义（P < 0.05），采用活检钳和细胞刷联合活检的阳性率高于单项活检（P = 0.019，P = 0.008）。结论 ERCP对于晚期胆囊癌合并恶性梗阻性黄疸患者有较好的退黄效果，改善了患者生活质量，可在患者无外科手术指征时取活检确诊胆囊癌，为进一步综合治疗提供病理依据。

Abstract:

Objective To explore the clinical value of endoscopic retrograde cholangiopancreatography (ERCP) in diagnosis and treatment of gallbladder carcinoma with malignant obstructive jaundice.Methods Clinical data of 20 patients with gallbladder cancer complicated with malignant obstructive jaundice from January 2016 to September 2019 were retrospectively analyzed. The levels of total bilirubin (TBil), direct bilirubin (DBil) and pathological tissues before and after ERCP were compared.Results There were statistical significances in TBil [(230.61 ± 100.73) vs (110.10 ± 55.02) μmol/L] and DBil [(190.93 ± 99.72) vs (88.13 ± 38.30) μmol/L] before and after ERCP treatment (P < 0.05). The positive rate of combined biopsy with biopsy forceps and cell brush was higher than that of single biopsy (P = 0.019, P = 0.008).Conclusion ERCP has a significant effect in treatment of gallbladder carcinoma with malignant obstructive jaundice, and is very helpful to improve the quality of life of patients. At the same time, ERCP can also take biopsy to diagnose gallbladder carcinoma when patients have no surgical indications, so as to provide pathological basis for further comprehensive treatment.