胰腺括约肌切开术后胰腺炎的患病风险:一项572例患者回顾

作     者：Hookey L.C. RioTinto R. Delhaye M. J.Devière 刘丽娜 

作者机构：Dept.of GastroenterologyEramus University HospitalRoute de lennik 8081070 BrusselsBelgium Dr. 

出 版 物：《世界核心医学期刊文摘（胃肠病学分册）》 (Core Journals in Gastroenterology)

年 卷 期：2006年第2卷第12期

页      面：22-22页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：括约肌切开 术后胰腺炎 患病风险 内镜操作 总胆管 手术适应证 胰胆管 引流术 技术性因素 经鼻 

摘      要：Background and study aims:Endoscopic pancreatic sphinc-terotomy is indispensable for many therapeutic endoscopic maneuvers,but is also associated with a higher risk of pancreatitis after endoscopic retrograde cholangiopancreatography(ERCP) .In this study,this subgroup of patients was investigated in order to identify risk factors and protective *** and methods:A retrospective chart review identified 572 endoscopic pancreatic sphincterotomies that met the inclusion *** were examined for indications,endoscopic technique,and outcomes,including ***:A total of 477 patients underwent 572 endoscopic pancreatic sphincterotomies during a 5-year *** for sphincterotomy included chronic pancreatitis(n = 398) ,access for tissue sampling(n = 52) ,acute recurrent pancreatitis(n = 45) ,transpapillary drainage of a pancreatic pseudocyst(n = 32) ,precut access to the common bile duct(n = 29) ,and others(n = 16) .Pancreatic duct drainage was performed in 69.1% of the procedures(nasopancreatic catheter,n = 290,or pancreatic stent placement,n = 105) .Post-ERCP pancreatitis occurred in 69 cases(12.1%) and was severe in *** multivariate analysis identified female sex as being associated with a higher risk of pancreatitis,while an elevated C-reactive protein level,pancreatic ductal stones,sphincterotomy at only the major papilla,and pancreatic duct drainage with a nasopancreatic catheter or stent were associated with a lower ***:This large series of patients undergoing endoscopic pancreatic sphincterotomy provides further evidence that both patient characteristics and technical factors modify the risk profile for post-ERCP *** addition to providing further definition of which patients are at risk,it also suggests that pancreatic duct drainage is an independently significant protective maneuver.