预防ERCP术后胰腺炎:不同操作技术的进展

Prevention of Post-ERCP Pancreatitis: Pro-gress in Different Procedural Techniques

内镜逆行胰胆管造影是治疗胰胆管疾病的重要技术。然而,治疗性ERCP仍与各种并发症有关,如ERCP术后胰腺炎、胆管炎、出血、胆囊炎和穿孔。此外,为了安全、成功地进行ERCP手术,最初选择性的胆管或胰腺插管是必要的,以减少潜在的并发症。选择性胆道插管仍有5%至10%的患者失败,尽管有多种内镜技术可用。为了克服插管困难,在不增加并发症发生率的情况下,设计了各种插管技术和设备。这篇文章就不同操作技术对于术后并发症的发生进行全面概述。

Endoscopic retrograde cholangiopancreatography (ERCP) is an important technique for the treat-ment of pancreaticobiliary diseases. However, therapeutic ERCP is still associated with various complications, such as post-ERCP pancreatitis, cholangitis, hemorrhage, cholecystitis, and perfora-tion. In addition, for a safe and successful ERCP procedure, initial selective bile duct or pancreatic cannulation is necessary to reduce potential complications. Selective biliary cannulation still fails in 5% to 10% of patients despite the availability of multiple endoscopic techniques. To overcome the difficulty of intubation, a variety of intubation techniques and devices have been designed without increasing the incidence of complications. This article provides a comprehensive overview of dif-ferent surgical techniques for the occurrence of postoperative complications.