RESUMO
Objective To evaluate the safety and efficacy of ultrosonography-guided two-stage ERCP for management of emergent pancreatobiliary diseases during pregnancy.Methods The clinical data of 32 consecutive pregnant women with suspected emergent pancreatobiliary diseases,who were treated with two-stage ultrasonography-guided ERCP from January 2005 to May 2010,were analyzed retrospectively.All patients were treated with ERCP in two stages. In stage Ⅰ,all the patients underwent ultrasonographyguided biliary cannulation,sphincterotomy with small incision and plastic stent placement during pregnancy.In stage Ⅱ,routine ERCP was performed in two weeks after delivery.The success rate of first ERCP,relief of clinical manifestation,improvement of lab indices,maternal and fetal complications were evaluated.Results All patients presented with fever,biliary colic and jaundice.Abdominal ultrasonography or magnetic resonance cholagiopancreatography (MRCP) revealed dilated common bile duct (CBD) in all patients,with CBD stones in 24 and acute cholangitis in 8.Bile duct cannulation and stent placement were successful in all patients.All patients markedly improved after first ERCP,with laboratory indices significantly improved at 1week after the procedure ( P ＜ 0.01 ).In stage Ⅱ,CBD stones were retrieved in 24 patients under ERCP,including 2 cases of mechanical lithotripsy.Bile duct stenosis was found in 3 patients and plastic stents were replaced.Biliary bleeding occurred in 1 case,mild acute pancreatitis in another,with a complication rate at 6.25％.Patients and babies were followed up for 12 months and found to be healthy.Conclusion Twostage ultrosonography-guided ERCP is safe and effective for pregnant patients with emergent pancreatobiliary diseases,which might be regarded as the first choice for such patients to avoid radiation.