摘要
目的 探讨诊断性胰、胆管显影与胆道支架、乳头括约肌切开取石术等治疗性逆行胰、胆管造影 (ERCP) ,对术后并发胰腺炎的影响。方法 412例ERCP操作分为 7组 :诊断性ERCP分为胆、胰双管显影 (ERCP)组、单纯胆管显影 (ERC)组与单纯胰管显影 (ERP)组 ,治疗性ERCP分为双管显影加支架术 (ERCP +支架 )组、ERC +支架组、ERCP +乳头肌切开 (EST)取石组及ERC +EST取石组 ,比较各组术后 4h、2 4h血清淀粉酶及临床症状改变。结果 术后 4h、2 4h高淀粉酶血症发生率为 17.7%及 4.4% ,并发急性胰腺炎的发生率为 3 .9% ,各组中以ERP组发病率为最高。结论 在ERCP操作中 ,反复胰管造影是并发术后胰腺炎主要危险因素 ,EST、支架治疗并不增加胰腺炎的发病率。
Objective To investigate the influence of endoscopic retrograde cholangiography (ERC), endoscopic retrograde pancreatography (ERP), endoscopic retrograde cholangiopancreatography (ERCP), endoscopic sphincterotomy (EST) and endoscopic biliary stenting on postoperative pancreatitis. Methods 412 patients referred to ERCP were divide into 7 groups, there were both biliary and pancreatic ducts group (ERCP), biliary duct contrast filling group (ERC), pancreatic duct contrast filling group (ERP), ERCP plus biliary stenting group (stent), ERC plus stent, ERCP plus EST and stone extraction (SE) group, and ERC plus EST and SE group. And the differences of postoperative serum amylase in 4 hours and in 24 hours as well as clinical symptoms were compared among different groups. Results The incidence of postoperative hyperamylasaemia in 4 hours and 24 hours were 17.7% and 4.4% respectively. The incidence of postoperative acute pancreatitis was 3.9%, and ERP group had the highest incidence of postoperative acute pancreatitis among the 7 groups. Conclusions Repeated pancreatic duct contrast filling during ERCP manipulation is the main risk factor for postoperative pancreatitis, and therapeutic ERCP such as EST, stent and SE does not increase the incidence of postoperative pancreatitis.
出处
《中华消化杂志》
CAS
CSCD
北大核心
2001年第5期284-286,共3页
Chinese Journal of Digestion
