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目的探讨经内镜针状刀乳头括约肌切开术(PST)治疗急性化脓性胆管炎的应用价值。方法对有结石嵌顿、炎性狭窄的乳头做常规逆行胰胆管造影术(ERCP)乳头插管失败后,进行针状刀电切,找到胆总管下端开口,成功后改用常规电刀切开或乳头气囊扩张,再行网篮取石、置管引流等。结果12例患者中11例取石成功,取石成功率为91.7%。结论乳头结石嵌顿、乳头炎性狭窄伴结石致急性化脓性胆管炎,在常规内镜乳头插管困难时,采用PST技术,患者可以得到有效的诊断和治疗。PST是内镜下治疗结石源性急性化脓性胆管炎的重要手段。
Objective To investigate the clinical value of endoscopic needle-knife papilla sphincterotomy (PST) in the treatment of acute suppurative cholangitis. [Methods] After the failed ERCP nipple intubation with incarcerated nipple and inflammatory stenosis, the acupuncture was performed to cut the lower end of the common bile duct. After the success, it was cut by a conventional electric knife Or nipple balloon expansion, and then basket stone, catheter drainage and so on. Results Of the 12 patients, 11 had successful stone extraction and 91.7% achieved stone success. Conclusion Nipple calculi, nipple stenosis with calculi induced acute suppurative cholangitis, when conventional endoscopic papillary intubation difficulties, the use of PST technology, patients can be effectively diagnosed and treated. PST is an important means of endoscopic treatment of acute suppurative cholangitis.