The Diagnostic And Therapeutic Value Of Endoscopic Retrograde Cholangiopancreatography For Severe Clonorchiasis Sinensis

Objective To assess the diagnostic and therapeutic value of endoscopic retrograde cholangiopancreatography(ERCP) for severe Clonorchiasis sinensis.Methods 101 patients with cholethiasis or unknown dialated bile duct were performed by RECP and data was analysised retrospectively , and 28 patie -nts with clonorchiasis sinensis were recruited to observation group. The clinical characteristics and therapeutic effect were analysised at the same time. Meanwh -ile 73 patients who underwent ERCP due to other suspected cholangiopancrea -tic abnormalities were assigned to diagnostic control group.Results In observation group,12 (42.8%) patients had diffuse saccular dilation of terminal intrahepatic bile duct,8 (28.6%) patients had partial cystic intrahepatic bile duct, 9 (32.1%) patients had oval filling defect within intrahepa -tic bile duct. The control group, only 2 (2.7%) patients had diffuse saccular dila -tion of terminal intrahepatic bile duct, and 1 (1.4%) patients had partial cystic intrahepatic bile duct, no patients had oval filling defect within intrahepatic bile duct. Observed group cleaned up the bile duct with stone baskets after sphincter -otomy (EST), 6 (21.4%) patients were seen a lot of "Buckwheat-like " floccule -nt material in bile,no such phenomenon in the control group. The positive rate of bile Clonorchis eggs test in observation group was 88.9% (8 / 9).In observed group ,all of 9 patients with abdominal pain reliefed , 21 of 22 patients with obstructive jaundice reduced and serum total bilirubin, alkaline phosphate -ase,GGT were decreased significantly after ERCP. There were no serious complications in observed group.Conclusions The diffuse saccular dilation of terminal intrahepatic bile duct, localized cystic dilation of intrahepatic bile duct , oval filling defect within intrahepatic bile duct and the visible signs such as "Buckwheat-like " flocculent material within bile are highly specific features of clonorchiasis sinensis. Absorp -tion of bile to find eggs of Clonorchis sinensis can increase the detection rate of infection.ERCP is one of effective and safe therapy modality for clonorchiasis biliary obstruction.