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目的分析经内镜逆行胰胆管造影(ERCP)并发急性胰腺炎的相关危险因素,以提高ERCP诊断及治疗水平,减少其发生率。方法回顾性分析了2003年6月至2007年7月于中国医科大学附属第一医院行诊断与治疗性ERCP的346例患者共399例次的临床资料。将患者按ERCP操作分为8组,比较各组术后24h血清淀粉酶及临床症状改变。结果399例次ERCP术后高淀粉酶血症发生率为12.5%(50/399),急性胰腺炎发生率为1.5%(6/399)。各组中高淀粉酶血症与急性胰腺炎发生率最高均为ERCP+胆管内支架组(分别为38.9%、11.1%)。399例次ERCP中,于2003年6月至2005年6月间进行153例次与2005年7月至2007年7月间进行的246例次比较,ERCP术后急性胰腺炎发生率分别为3.3%(5/153)、0.4%(1/246),差异有显著性意义。结论在ERCP操作中,胰管显影及术者经验是并发术后急性胰腺炎主要危险因素。
Objective To analyze the related risk factors of endoscopic retrograde cholangiopancreatography (ERCP) complicated with acute pancreatitis in order to improve the diagnosis and treatment of ERCP and reduce its incidence. Methods A total of 399 clinical data of 346 patients diagnosed and treated with ERCP at the First Affiliated Hospital of China Medical University from June 2003 to July 2007 were retrospectively analyzed. The patients were divided into 8 groups according to the ERCP operation, serum amylase and clinical symptoms were compared between the groups after 24h. Results The incidence of hyper amylase in 399 cases after ERCP was 12.5% (50/399) and acute pancreatitis was 1.5% (6/399). In each group, the highest incidence of high amylasemia and acute pancreatitis were ERCP + biliary stent group (38.9% and 11.1% respectively). In the 399 ERCPs, 153 cases were performed between June 2003 and June 2005 compared with 246 cases between July 2005 and July 2007. The incidence of acute pancreatitis after ERCP was 3.3 % (5/153), 0.4% (1/246), the difference was significant. Conclusions In ERCP operation, the development of pancreatic duct and the experience of the surgeon are the main risk factors for postoperative acute pancreatitis.