【摘要】 目的探讨经内镜逆行胰胆管造影(ERCP)术后并发胰腺炎的发生率及相关危险因素。方法回顾性分析南昌大学第一附属医院2017年1—12月行ERCP患者的临床资料,统计ERCP术后并发胰腺炎的发生率并分析其发生的危险因素。结果 2115例患者接受了ERCP手术,符全入选标准者1419例。ERCP者术后胰腺炎的发生率为7.68%(109/1419)。十二指肠乳头括约肌切开术、胆管狭窄、导丝进入胰管者ERCP术后胰腺炎发生率更高(P<0.05)。胰管支架置入明显降低ERCP术后胰腺炎的发生率(P<0.05)。结论十二指肠乳头括约肌切开术、胆管狭窄、导丝进入胰管为ERCP术后胰腺炎的危险因素。在操作过程中,对于胆管狭窄的患者,应谨慎操作,能不进行EST应尽量避免;若是单纯取胆管结石,应尽量避免导丝进入胰管,如果进入胰管,建议置放胰管塑料支架。更多还原

【Abstract】 Objective To investigate the incidence of post-endoscopic retrograde cholangiopancreatography(ERCP) pancreatitis(PEP) and its related risk factors.Methods Clinical data of patients who underwent ERCP in the First Affiliated Hospital of Nanchang University from January to December 2017 were reviewed retrospectively.The incidence of PEP and its risk factors were analyzed.Results A total of 2115 patients received ERCP,and 1419 of them were enrolled according to the inclusion criteria.The incidence of PEP was 7.68%(109/1419).Duodenal papillary sphincterotomy,bile duct stricture and pancreatic guide-wire placement increased incidence of PEP(P<0.05).However,pancreatic stent implantation reduced the incidence of PEP(P<0.05).Conclusion Duodenal papillary sphincterotomy,bile duct stricture and pancreatic guide-wire placement are risk factors for PEP.For patients with bile duct stenosis,care should be taken to avoid the performance of endoscopic sphincterotomy as far as possible.If only bile duct stones are taken,pancreatic guide-wire placement should be avoided and plastic pancreatic stent implantation is recommended.更多还原