EST对预防急性胆源性胰腺炎复发的临床价值

Clinical implications of endoscopic sphincterotomy in preventing recurrence of acute biliary pancreatitis

目的探讨内镜下乳头括约肌切开(endoscopic sphincterotomy,EST)对预防急性胆源性胰腺炎(acutebiliary pancreatitis,ABP)复发的临床价值。方法将临床治愈的296例ABP患者分为EST治疗组(n=119)和非EST对照组(n=177)。将两组患者进一步分为胆囊切除组和非胆囊切除组。随访所有ABP患者,比较两组复发率有无显著差异。结果两组ABP患者平均随访时间32±14月;15例失访,随访率94.9%。EST治疗组(11/113)的复发率明显低于非EST治疗组(75/168),差异有显著性(P<0.01);胆囊切除虽然能降低ABP的复发率,但其差异无显著性地(P>0.05)。结论应用EST技术治疗ABP,可预防ABP的再次发作。

Objective To determine the clinical value of endoscopic sphincterotomy （EST） in preventing the recurrence of acute biliary pancreatitis （ABP）. Methods Two hundred and ninety-six cured patients with ABP were divided into EST treatment group （n = 119） and non-EST control group （n = 177）. Each group was further broken down into cholecystectomy group and non-cholecystectomy group. Follow-up visits were paid to all patients with ABP and comparisons were made to see whether the recurrence rate of the cases between the two groups had any significant importance. Results All patients with ABP, except 15 patients who were loss to follow up, were followed up for 32 ± 14 months, with a response rate being 94.9%. The recurrence rate for the cases in EST group （11/113） was significantly lower than that in non-EST control group （75/168） （P 〈 0.01）. However, there was no significant difference between cholecystectomy group and non-cholecystectomy group when further comparison was made （P 〉 0.05）, although cholecystectomy could reduce the recurrence rate of the patients with ABP. Conclusion The treatment of patients with ABP by using EST can prevent the recurrence of the disease.