Clinical application of ERCP combined with biliary microlithiasis exploration in acute cholangitis / 中国医师进修杂志

ABSTRACT

Objective To study the clinical application of endoscopic retrograde cholangiopancre-atography(ERCP)combined with biliary microlithiasis exploration in acute cholangitis.Methods The clinical data of consecutive 54 cases of acute cholangitis were analyzed.Before ERCP,all cases were examined by routine examinations,including abdominal uhrasonography,CT or magnetic resonance cholangiopancre atography(MRCP).The bile Was collected through ERCP or endoscopic mtsobiliary drainage(ENBD),then all the samples were choked by polarization microscope.Results Thirty-six cases(66.67%)out of 54 patients with common bile duct(CBD)stones or dilation of common bile duct were diagnosed by routine examination.ERCP Was performed in all patients,only 3 cases failed,and the rest were successful.Through ERCP,39 cases with CBD stones(76.47%),4 cases with CBD inflamnmtory smcmre were diagnosed,and 12 cases were normal.Among the 12 cases,9 cages were found with biliary microlithiasis by polarization microscope.The diagnostic effectiveness of ERCP combined with biliary microlithiasis exploration was highest(94.12%),and there Was significant difference between them(P＜0.05).Conclusions It may improve the diagnostic accuracy to combine ERCP with biliary microlithiasis exploration in CBD stones.Biliary microlithiasis may play an important role in the pathogenesis in unknown aetiology acute unexplained cholangitis.