ERCP in acute pancreatitis:What takes place in routine clinical practice?

作     者：Armando Gabbrielli Raffaele Pezzilli Generoso Uomo Alessandro Zerbi Luca Frulloni Paolo De Rai Laura Castoldi Guido Costamagna Claudio Bassi Valerio Di Carlo 

作者机构：Department of Surgical and Gastroenterological SciencesUniversity of Verona Department of Digestive Diseases and Internal MedicineS.Orsola-Malpighi Hospital Department of Internal Medicine Department of SurgeryHumanitas Hospital Department of Emergency SurgeryFondazione IRCCS MaggioreMangiagalli and Regina Elena Hospital Digestive Endoscopy Unit"Agostino Gemelli" University HospitalCatholic University of Rome Rome 00100Italy Department of SurgeryUniversity Vita e Salute 

出 版 物：《World Journal of Gastrointestinal Endoscopy》 (世界胃肠内镜杂志（英文版）（电子版）)

年 卷 期：2010年第2卷第9期

页      面：308-313页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：Supported by an Unrestricted Grant from Sanofi-Aventis Milan Italy 

主　　题：Acute pancreatitis Epidemiology,Endoscopic retrograde cholangiopancreatography Data collection 

摘      要：AIM:To evaluate the data from a survey carried out in Italy regarding the endoscopic approach to acute pancreatitis in order to obtain a picture of what takes place after the release of an educational project on acute pancreatitis sponsored by the Italian Association for the Study of the ***:Of the 1 173 patients enrolled in our survey,the most frequent etiological category was biliary forms(69.3%) and most patients had mild pancreatitis(85.8%).RESULTS:344/1 173(29.3%) underwent endoscopic retrograde cholangiopancreatography(ERCP).The mean interval between the onset of symptoms and ERCP was 6.7 ± 5.0 d;only 89 examinations(25.9%) were performed within 72 h from the onset of *** main indications for ERCP were suspicion of common bile duct stones(90.3%),jaundice(44.5%),clini cal worsening of acute pancreatitis(14.2%) and cho langitis(6.1%).Biliary and pancreatic ducts were visua lized in 305 patients(88.7%) and in 93 patients(27.0%) *** success rate in obtaining a cholangio gram was statistically higher(P = 0.003) in patients with mild acute pancreatitis(90.6%) than in patients with severe disease(72.2%).Biliary endoscopic sphinc terotomy was performed in 295 of the 305 patients(96.7%) with no difference between mild and severe disease(P = 0.985).ERCP morbidity was 6.1% and mortality was 1.7%;the mortality was due to the complications of acute pancreatitis and not the endoscopic ***:The results of this survey,as with those carried out in other countries,indicate a lack of compliance with the guidelines for the indications for interventional endoscopy.