关键词: 胆源性肝损伤, 磁共振胰胆管造影, 内镜逆行胰胆管造影, 临床特征, 预后

Abstract: Objective The aim of this study was to summarize the clinical features of patients with biliary liver injury (BLI) and observe the magnetic resonance cholangiopancreatography(MRCP)and endoscopic retrograde cholangiopancreatography(ERCP) results. Methods 77 patients with BLI were recruited in our hospital between January 2018 and December 2019, and all underwent MRCP and ERCP, and endoscopic sphincterotomy (EST) when necessary. Result Among the 77 patients, the clinical symptoms and sign included jaundice in 70 cases (90.9%), abdominal pain in 65 cases (84.4%), and fever in 27 cases (35.1%), and the MRCP found negative in 34 and positive in 43 cases; the ultrasound examination showed cholelithiasis in 48 cases(62.3%), and cholecystectomy history in 14 cases (18.2%); 71 cases (92.2%) were diagnosed as choledocholithiasis by ERCP, and the percentage of mud-like stones in common bile duct in MRCP negative group was 91.2%, significantly higher than 9.3% in MRCP positive group; there was no significant differences respect to age, gender, incidence of abdominal pain and jaundice between the two groups(P＞0.05); the incidence of fever in the MRCP negative group was 20.6%, significantly lower than 46.5% in MRCP positive group (P＜0.05); the percentage of neutrophils in MRCP negative group was (66.6±14.4)%, significantly lower than (74.6±14.8)% in MRCP positive group (P＜0.05); there were no significant differences respect to blood biochemical parameters between the two groups (P>0.05); the success rates and the complication rates of ERCP in the two groups were not significantly different(P＞0.05). Conclusion The mud-like stones in common bile duct are the most common cause of BLI in MRCP negative patients, and the ERCP is a safe and effective treatment for the patients with BLI when the MRCP examination is negative.

Key words: Biliary liver injury, Magnetic resonance cholangiopancreatography, Endoscopic retrograde cholangiopancreatography, Clinical features, Prognosis