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首页> 外文期刊>Surgical Endoscopy >Endoscopic stenting for selected cases of biliary fistula after hepatic hydatid surgery.
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Endoscopic stenting for selected cases of biliary fistula after hepatic hydatid surgery.

机译：内镜支架置入术治疗肝胆囊病后胆道瘘的特定病例。

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BACKGROUND: Biliary fistula develops in 4%-28% of patients after hepatic hydatid disease (HHD) surgery. Although endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (ES) are helpful in the treatment of this complication, persistent fistulas may occur. We therefore conducted a study to evaluate the efficacy of endoscopic biliary stenting in the treatment of biliary fistulas after HHD. METHODS: In this study, 84 patients who underwent ERCP for postoperative biliary fistula due to HHD were evaluated. Group I included 70 patients treated with only ES, and group II included 14 patients who underwent biliary stenting as their initial treatment. Demographic data, complications, the results of treatment and the reasons for the failure were compared between two groups. RESULTS: Ninety-five ERCPs were performed. In 63 patients, biliary fistulas were successfully treated with only ERCP and ES. However, 7 patients underwent repeat ERCP and stent placement because of persistent fistula. Biliary stenting was initially performed in 14 patients. The average time for closure of the fistula was 14 +/- 10 days and 7 +/- 3 days in group I (7 patients with repeat ERCP were excluded) and group II, respectively (p = 0.007). There was no statistically significant difference in the complication rates between the groups. CONCLUSIONS: Although ES is effective in the treatment of biliary fistula after HHD surgery, endoscopic biliary stenting may be considered as the initial procedure in patients with biliary stricture, incomplete clearance of hydatid material in the bile duct, and persisting biliary fistulas after treatment with ERCP and ES.
机译：背景：肝胆囊病（HHD）手术后，有4％-28％的患者发生胆道瘘。尽管内镜逆行胰胆管造影（ERCP）和内镜括约肌切开术（ES）有助于治疗该并发症，但可能会发生持续性瘘管。因此，我们进行了一项研究，以评估内镜胆道支架置入术治疗HHD后胆道瘘管的疗效。方法：在本研究中，对84例因HHD术后胆道瘘行ERCP的患者进行了评估。第一组包括70例仅接受ES治疗的患者，第二组包括14例接受了胆道支架置入术的患者。比较两组的人口统计学数据，并发症，治疗结果和失败原因。结果：执行了九十五个ERCP。在63例患者中，仅使用ERCP和ES成功治疗了胆道瘘管。但是，由于瘘管持续存在，有7例患者再次进行了ERCP和支架置入术。最初有14例患者进行了胆道支架置入术。 I组（排除7例重复ERCP的患者）和II组的平均瘘管闭合时间分别为14 +/- 10天和7 +/- 3天（p = 0.007）。两组之间的并发症发生率无统计学差异。结论：尽管ES在HHD手术后可有效治疗胆道瘘，但内镜下胆道支架置入术可被认为是胆道狭窄，胆囊中的hy虫物质清除不完全以及ERCP治疗后胆道瘘持续存在的患者的初始手术和ES。

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