Application of ERCP in patients with hepatic hydatid disease complicated with biliary tract disease in Lhasa
Objective This study aimed to report the application of endoscopic retrograde cholangiopancreatography(ERCP)in patients with hepatic hydatid disease(HHD)in Lhasa,Xizang,and to explore the application value of ERCP in these patients.Methods By reviewing cases of HHD treated with ERCP at Lhasa People's Hospital from June 2019,to August 2023,the patients were divided into three groups based on whether they underwent hepatic hydatid surgery operation and the timing of the surgery.The groups were the preoperative ERCP group(2 cases),postoperative ERCP group(3 cases),and non-operation group(11 cases,12 times).The study evaluated the application value of ERCP in patients with hepatic echinococcosis.Results A total of 16 patients(17 times)with HHD who underwent ERCP were included in this study(cyst type∶alveolar type=12∶4),with an average age of(54.38±21.93)years and a male-to-female ratio of 1∶1.67.Nine cases(56.25%)had choledocholithiasis,and 5 cases(31.25%)had biliary strictures.In the preoperative ERCP group,all patients underwent endoscopic nasobiliary drainage(ENBD)for acute cholangitis.In the postoperative ERCP group,one case underwent ENBD for postoperative biliary leakage,and two cases underwent ERCP for stone removal due to recurrence of choledocholithiasis after hepatic echinococcosis surgery.In the non-operation group,6 cases(7 times)underwent ERCP for choledocholithiasis,3 cases underwent endoscopic biliary drainage for biliary stricture,1 case underwent endoscopic biliary clearance for the intrabiliary rupture of hepatic hydatid cyst combined with choledocholithiasis,and 1 case underwent ERCP for acute cholangitis caused by a white flat membrane-like material in the biliary tract.ERCP-related complications occurred in one case(5.88%),namely,biliary hemorrhage,which was relieved by conservative therapy.After surgery and ERCP treatment,8 cases(50.00%)were cured,5 cases(31.25%)were obviously relieved,and 3 cases(18.75%)were slightly relieved.With a follow-up of(28.56±17.11)months,13 cases had a good outcome,and 3 cases died at 29,31,and 44 months after ERCP,respectively.The therapeutic effect was significantly better in patients with cystic echinococcosis compared to patients with alveolar echinococcosis(P<0.05).Conclusions ERCP is safe and effective for the treatment of acute cholangitis,biliary leakage,biliary stricture,choledocholithiasis,and intrabiliary rupture of the hepatic hydatid cyst in patients with HHD.
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