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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 effects of diagnostic pancreaticobiliary ductography and biliary stents, nipple sphincterotomy and other therapeutic retrograde pancreas and cholangiography (ERCP) on postoperative pancreatitis. Methods 412 cases of ERCP were divided into 7 groups: diagnostic ERCP was divided into gallbladder and pancreatic ducts (ERCP) group, simple cholangiography (ERC) group and simple pancreatic duct imaging (ERP) group. The therapeutic ERCP was divided into two groups ERCP + scaffold group, ERCP + EST group and ERC + EST stone group. The changes of serum amylase and clinical symptoms at 4h and 24h after operation were compared between the two groups . Results The incidence of hyper amylase at 24 hours and 24 hours after operation was 17.7% and 4.4% respectively, and the incidence of acute pancreatitis was 3.9%. The incidence of ERP in each group was the highest. Conclusions In ERCP operation, repeated pancreatic duct angiography is the main risk factor for postoperative pancreatitis. EST and stent treatment do not increase the incidence of pancreatitis.