目的：回顾本中心应用经内镜逆行胰胆管造影术（endoscopic retrograde cholangio-pancreatography, ERCP）在原发性肝癌围术期胆道并发症临床诊治中的经验。方法：回顾性分析2016年10月至2023年6月我院原发性肝癌诊治过程中围术期因胆道并发症行ERCP治疗病人的临床资料。依据胆道并发症行ERCP的指征，病例分为胆管癌栓组、胆管狭窄组和胆漏组。统计分析原发性肝癌围术期不同类型胆道并发症病人的基线资料、ERCP治疗前后的实验室指标、治疗转归等数据。结果：总计25例行25例次ERCP，其中23例插管成功，成功率92.0%。胆管狭窄14例次，主要行胆道球囊扩张、探条扩张、支架植入、鼻胆管引流治疗；胆漏6例次，主要行支架植入、鼻胆管引流治疗；胆管癌栓5例次，主要行网篮及气囊取栓、支架植入、鼻胆管引流治疗。ERCP治疗后病人血清总胆红素、血清直接胆红素、γ-谷氨酰转移酶较治疗前明显下降（P<0.05）。术后平均血淀粉酶（85.0±69.4）（21~306） U/L。所有病例均无出血、消化道穿孔、胰腺炎及其他ERCP相关并发症发生。结论：原发性肝癌围术期胆道并发症以胆管狭窄最为常见。对于有胆道并发症的原发性肝癌围术期病人，行ERCP治疗安全、有效。

Objective: To review the experience of using endoscopic retrograde cholangio-pancreatography (ERCP) in the clinical diagnosis and treatment of biliary complications during perioperative period of primary liver cancer at our hospital. Methods: A retrospective analysis was conducted on the clinical data of patients undergoing ERCP treatment for biliary complications during perioperative period of primary liver cancer at our hospital from October 2016 to June 2023. According to the indications of ERCP for biliary complications, the cases were divided into bile duct tumor thrombus group, bile duct stricture group, and bile leakage group. The baseline data, laboratory test results before and after ERCP treatment, treatment outcomes, and other datas of the patients with different types of biliary complication were statistically analyzed. Results: A total of 25 patients underwent 25 cases of ERCP, among which 23 patients were successfully cannulated, with a success rate of 92.0%. There were 14 cases of bile duct stenosis, mainly treated with biliary balloon dilation, probe dilation, stent implantation, and nasobiliary drainage; 6 cases of bile leakage, mainly treated with stent implantation and nasobiliary drainage; 5 cases of bile duct tumor thrombus, mainly treated with net basket and balloon thrombectomy, stent implantation, and nasobiliary drainage. After ERCP treatment, the patient's serum total bilirubin, serum direct bilirubin, and γ-glutamyl transferase significantly decreased compared to those before the treatment (P<0.05). The postoperative average amylase was (85.0±69.4)(21-306) U/L. No bleeding, gastrointestinal perforation, pancreatitis, or other ERCP-related complications occurred in all cases. Conclusions: Bile duct stricture is the most common biliary complication during the perioperative period of primary liver cancer. For these patients with biliary complications during perioperative period of primary liver cancer ERCP treatment is safe and effective.