Objective:To study the role of nursing risk management in the prevention of post-ERCP pancreatitis.Methods:80 patients who underwent ERCP in our hospital from December 2023 to April 2024 were selected and randomly div...Objective:To study the role of nursing risk management in the prevention of post-ERCP pancreatitis.Methods:80 patients who underwent ERCP in our hospital from December 2023 to April 2024 were selected and randomly divided into an observation group and a control group using the random number table method,with 40 cases in each group.The observation group was given nursing risk management interventions and patients in the control group were given routine nursing interventions,and the patients in the two groups were compared in the incidence rate of pancreatitis and the satisfaction of nursing care.Results:The incidence of postoperative pancreatitis in the observation group was significantly lower than in the control group(P<0.05).The patient satisfaction of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:Nursing risk management after ERCP can reduce the incidence of postoperative pancreatitis and improve patient satisfaction.展开更多
Background:Abdominal pain is often observed after endoscopic retrograde cholangiopancreatography(ERCP).Few studies have focused on the risk factors of post-ERCP abdominal pain without post-ERCP pancreatitis(PEP).This ...Background:Abdominal pain is often observed after endoscopic retrograde cholangiopancreatography(ERCP).Few studies have focused on the risk factors of post-ERCP abdominal pain without post-ERCP pancreatitis(PEP).This study aimed to identify risk factors of post-ERCP abdominal pain without PEP and investigate characteristics of the abdominal pain in non-PEP patients.Methods:Data from patients who underwent ERCP from August 2019 to January 2020 were retrospectively collected.Characteristics of the abdominal pain after ERCP were recorded and compared between PEP and non-PEP patients.Multivariate analysis was conducted to identify risk factors of non-PEP abdominal pain.Results:A total of 1295 ERCP procedures were investigated in this study,among which 100(7.72%)patients presented post-ERCP abdominal pain without PEP and 63(4.86%)patients with PEP.Multivariate analysis found 9 risk factors of non-PEP abdominal pain:age≤65 years[odds ratio(OR):1.971],primary ERCP(OR:2.442),dilated extrahepatic bile duct(OR:1.803),no papilla opening(OR:2.095),pancreatic guidewire passages(OR:2.258),white blood cells(WBC)≤6.0×10^(9)/L(OR:1.689),platelet(PLT)≤250×10^(9)/L(OR:2.505),serumγ-glutamyl transferase(γ-GT)≤35 U/L(OR:2.190),and albumin≥40 g/L(OR:1.762).The PEP group had later pain onset,higher pain frequency and longer hospital stay than those of the non-PEP pain group(P<0.05).There were no significant differences in the pain duration,visual analogue scale score and mortality between the PEP group and non-PEP pain group(P>0.05).Conclusions:This study indicated that age≤65 years,primary ERCP,dilated extrahepatic bile duct,no papilla opening,pancreatic guidewire passages,lower WBC,lower PLT,normalγ-GT and elevated albumin were independent risk factors for post-ERCP abdominal pain without PEP.The pain occurred earlier in non-PEP patients than in PEP patients.展开更多
Background:?Endoscopic retrograde cholangiopancreatography (ERCP) is commonly performed for biliary drainage and examination of the biliary and pancreatic duct before pancreaticoduodenectomy (PD). The influence of pre...Background:?Endoscopic retrograde cholangiopancreatography (ERCP) is commonly performed for biliary drainage and examination of the biliary and pancreatic duct before pancreaticoduodenectomy (PD). The influence of preoperative post-ERCP pancreatitis on PD is unknown. The aim of this study was to evaluate the relation between post-ERCP pancreatitis before PD and surgical outcomes of PD. Methods: We examined 38 patients who underwent PD. The relations between post-ERCP pancreatitis before PD and perioperative factors of PD such as patient characteristics, operative findings, and postoperative course were evaluated with univariate and multivariate analyses. Results: Post-ERCP pancreatitis was observed in 12 (37.5%) of the 38 patients. Univariate analyses showed operative procedure (P?= 0.034), operation time (P?= 0.004), blood loss (P?= 0.031), C-reactive protein (P?= 0.043), and delayed gastric emptying (P?= 0.035) to be significantly associated with post-ERCP pancreatitis. Multivariate analyses showed operation time (OR, 1.017;?95%CI, 1.000 - 1.034;?P?= 0.049) and delayed gastric emptying (OR, 18.72;95%CI, 1.139 - 307.6;?P?= 0.040) to be significantly associated with post-ERCP pancreatitis. Conclusions: Post-ERCP pancreatitis was associated with prolonged operation time and delayed gastric emptying in patients undergoing PD.展开更多
Background:Post-ERCP pancreatitis(PEP)is significantly influenced by the reflux of duodenal fluid.While gastrointestinal decompression represents a fundamental approach in acute pancreatitis management,the effectivene...Background:Post-ERCP pancreatitis(PEP)is significantly influenced by the reflux of duodenal fluid.While gastrointestinal decompression represents a fundamental approach in acute pancreatitis management,the effectiveness of immediate duodenal decompression following ERCP to prevent PEP remains uncertain.This study aimed to investigate the impact of immediate duodenal decompression after ERCP on reducing the incidence of hyperamylasemia and PEP.Methods:This retrospective study encompassed patients with native papilla who underwent therapeutic ERCP for choledocholithiasis at the Department of Gastroenterology,Chun’an Branch of Zhejiang Provincial People’s Hospital(Zhejiang,China)between January 2020 and June 2023.Based on the immediate placement of a duodenal decompression tube post-ERCP,patients were categorized into two groups:the duodenal decompression group and the conventional procedure group.Primary outcomes included the incidence of PEP and hyperamylasemia.Results:A total of 195 patients were enrolled(94 in the duodenal decompression group and 101 in the conventional procedure group).Baseline clinical and procedural characteristics exhibited no significant differences between the two groups.PEP occurred in 2 patients(2.1%)in the duodenal decompression group,in contrast to 11 patients(10.9%)in the conventional procedure group(Risk difference[RD]8.8%;95%confidence interval[CI]1.7%-16.5%,P=0.014).Hyperamylasemia was observed in 8 patients(8.5%)in the duodenal decompression group,compared to 20 patients(19.8%)in the conventional procedure group(RD 11.3%;95%CI 1.4%-21.0%;P=0.025).Patients with PEP in both groups showed improvement after receiving active treatment.No severe cases of PEP occurred in either group,and no serious adverse events related to duodenal catheter decompression were reported.Conclusion:Immediate duodenal decompression following ERCP demonstrates an effective reduction in the incidence of hyperamylasemia and PEP.展开更多
文摘Objective:To study the role of nursing risk management in the prevention of post-ERCP pancreatitis.Methods:80 patients who underwent ERCP in our hospital from December 2023 to April 2024 were selected and randomly divided into an observation group and a control group using the random number table method,with 40 cases in each group.The observation group was given nursing risk management interventions and patients in the control group were given routine nursing interventions,and the patients in the two groups were compared in the incidence rate of pancreatitis and the satisfaction of nursing care.Results:The incidence of postoperative pancreatitis in the observation group was significantly lower than in the control group(P<0.05).The patient satisfaction of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:Nursing risk management after ERCP can reduce the incidence of postoperative pancreatitis and improve patient satisfaction.
基金supported by a grant from the National Natural Science Foundation of China(81871947)。
文摘Background:Abdominal pain is often observed after endoscopic retrograde cholangiopancreatography(ERCP).Few studies have focused on the risk factors of post-ERCP abdominal pain without post-ERCP pancreatitis(PEP).This study aimed to identify risk factors of post-ERCP abdominal pain without PEP and investigate characteristics of the abdominal pain in non-PEP patients.Methods:Data from patients who underwent ERCP from August 2019 to January 2020 were retrospectively collected.Characteristics of the abdominal pain after ERCP were recorded and compared between PEP and non-PEP patients.Multivariate analysis was conducted to identify risk factors of non-PEP abdominal pain.Results:A total of 1295 ERCP procedures were investigated in this study,among which 100(7.72%)patients presented post-ERCP abdominal pain without PEP and 63(4.86%)patients with PEP.Multivariate analysis found 9 risk factors of non-PEP abdominal pain:age≤65 years[odds ratio(OR):1.971],primary ERCP(OR:2.442),dilated extrahepatic bile duct(OR:1.803),no papilla opening(OR:2.095),pancreatic guidewire passages(OR:2.258),white blood cells(WBC)≤6.0×10^(9)/L(OR:1.689),platelet(PLT)≤250×10^(9)/L(OR:2.505),serumγ-glutamyl transferase(γ-GT)≤35 U/L(OR:2.190),and albumin≥40 g/L(OR:1.762).The PEP group had later pain onset,higher pain frequency and longer hospital stay than those of the non-PEP pain group(P<0.05).There were no significant differences in the pain duration,visual analogue scale score and mortality between the PEP group and non-PEP pain group(P>0.05).Conclusions:This study indicated that age≤65 years,primary ERCP,dilated extrahepatic bile duct,no papilla opening,pancreatic guidewire passages,lower WBC,lower PLT,normalγ-GT and elevated albumin were independent risk factors for post-ERCP abdominal pain without PEP.The pain occurred earlier in non-PEP patients than in PEP patients.
文摘Background:?Endoscopic retrograde cholangiopancreatography (ERCP) is commonly performed for biliary drainage and examination of the biliary and pancreatic duct before pancreaticoduodenectomy (PD). The influence of preoperative post-ERCP pancreatitis on PD is unknown. The aim of this study was to evaluate the relation between post-ERCP pancreatitis before PD and surgical outcomes of PD. Methods: We examined 38 patients who underwent PD. The relations between post-ERCP pancreatitis before PD and perioperative factors of PD such as patient characteristics, operative findings, and postoperative course were evaluated with univariate and multivariate analyses. Results: Post-ERCP pancreatitis was observed in 12 (37.5%) of the 38 patients. Univariate analyses showed operative procedure (P?= 0.034), operation time (P?= 0.004), blood loss (P?= 0.031), C-reactive protein (P?= 0.043), and delayed gastric emptying (P?= 0.035) to be significantly associated with post-ERCP pancreatitis. Multivariate analyses showed operation time (OR, 1.017;?95%CI, 1.000 - 1.034;?P?= 0.049) and delayed gastric emptying (OR, 18.72;95%CI, 1.139 - 307.6;?P?= 0.040) to be significantly associated with post-ERCP pancreatitis. Conclusions: Post-ERCP pancreatitis was associated with prolonged operation time and delayed gastric emptying in patients undergoing PD.
基金Zhejiang Province Traditional Chinese Medicine Science and Technology Plan Project(No.2023ZL266).
文摘Background:Post-ERCP pancreatitis(PEP)is significantly influenced by the reflux of duodenal fluid.While gastrointestinal decompression represents a fundamental approach in acute pancreatitis management,the effectiveness of immediate duodenal decompression following ERCP to prevent PEP remains uncertain.This study aimed to investigate the impact of immediate duodenal decompression after ERCP on reducing the incidence of hyperamylasemia and PEP.Methods:This retrospective study encompassed patients with native papilla who underwent therapeutic ERCP for choledocholithiasis at the Department of Gastroenterology,Chun’an Branch of Zhejiang Provincial People’s Hospital(Zhejiang,China)between January 2020 and June 2023.Based on the immediate placement of a duodenal decompression tube post-ERCP,patients were categorized into two groups:the duodenal decompression group and the conventional procedure group.Primary outcomes included the incidence of PEP and hyperamylasemia.Results:A total of 195 patients were enrolled(94 in the duodenal decompression group and 101 in the conventional procedure group).Baseline clinical and procedural characteristics exhibited no significant differences between the two groups.PEP occurred in 2 patients(2.1%)in the duodenal decompression group,in contrast to 11 patients(10.9%)in the conventional procedure group(Risk difference[RD]8.8%;95%confidence interval[CI]1.7%-16.5%,P=0.014).Hyperamylasemia was observed in 8 patients(8.5%)in the duodenal decompression group,compared to 20 patients(19.8%)in the conventional procedure group(RD 11.3%;95%CI 1.4%-21.0%;P=0.025).Patients with PEP in both groups showed improvement after receiving active treatment.No severe cases of PEP occurred in either group,and no serious adverse events related to duodenal catheter decompression were reported.Conclusion:Immediate duodenal decompression following ERCP demonstrates an effective reduction in the incidence of hyperamylasemia and PEP.
