经内镜逆行胰胆管造影术后并发急性胰腺炎的相关危险因素分析

Analysis of the correlation risk factors for acute pancreatitis induced by ERCP

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 assess the related risk factors of endoscopic retrograde cholangiopancreatography（ERCP） on postoperative pancreatitis. To improve the level of diagnostic and therapeutic ERCP,to reduce the incidence of postoperative panereatitis. Methods A total of 346 patients in our hospital referred to diagnostic and therapeutic ERCP（399 frequency） were divided into 8 groups;the differences of postoperative serum amylase in 24 hour as well as clinical symptoms were compared among different groups. Results The incidence of postoperative hyperamylasaemia was 12. 5 %. The incidence of postoperative acute panereatitis was 1.5 %. ERCP ＋ STENT therapeutic group （ 38.9% ） had the highest incidence of postoperative hyperamylasaemia and postoperative acute panereatitis among the groups. （ respectively 38.9%, 11.1% ）. There was the different incidence of postoperative aetete panereatitis between the period from June 2003 to June 2005 and from July 2005 to July 2007 ,respectively 3.3% ,0. 4%. Conclusion Pancreatic duct contrast filling and deficient experience of doctor during ERCP manipulation are the main risk factors for postoperative pancreatitis.