| 胰管支架表面括约肌预切开在ERCP困难胆管插管中的应用效果 |
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| 引用本文： | 李谦益,姚文飞,祁洋,姚伟,孔雷,徐瑞云,陆一凡,陈胜,王建承,吴卫泽,李能平. 胰管支架表面括约肌预切开在ERCP困难胆管插管中的应用效果[J]. 肝胆胰外科杂志, 2022, 34(3): 129-133. DOI: 10.11952/j.issn.1007-1954.2022.03.001 |
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| 作者姓名： | 李谦益 姚文飞 祁洋 姚伟 孔雷 徐瑞云 陆一凡 陈胜 王建承 吴卫泽 李能平 |
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| 作者单位： | 上海交通大学医学院附属瑞金医院 普外科 ,上海 200025 |
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| 基金项目： | 上海市卫生和健康委员会科研课题 |
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| 摘 要： | 目的 探讨胰管支架表面括约肌预切开(PPDS)在ERCP困难胆管插管中的应用效果.方法 回顾性统计分析2016年6月1日至2021年5月31日上海交通大学医学院附属瑞金医院北部院区所有ERCP术病例资料,将在ERCP操作过程中导丝意外进入胰管的困难胆管插管者,根据术中选择插管方法,分为两组:(1)PPDS组,(2)双导...
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| 关 键 词： | 内镜逆行胰胆管造影术(ERCP) 困难胆管插管 胰管支架表面括约肌预切开 双导丝 经胰管括约肌切开 |
| 收稿时间： | 2021-12-27 |
Efficacy of precut over a pancreatic duct stent for difficult biliary cannulation in ERCP |
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| LI Qianyi,YAO Wenfei,QI Yang,YAO Wei,KONG Lei,XU Ruiyun,LU Yifan,CHEN Sheng,WANG Jiancheng,WU Weize,LI Nengping. Efficacy of precut over a pancreatic duct stent for difficult biliary cannulation in ERCP[J]. Journal of Hepatopancreatobiliary Surgery, 2022, 34(3): 129-133. DOI: 10.11952/j.issn.1007-1954.2022.03.001 |
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| Authors: | LI Qianyi YAO Wenfei QI Yang YAO Wei KONG Lei XU Ruiyun LU Yifan CHEN Sheng WANG Jiancheng WU Weize LI Nengping |
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| Affiliation: | Department of General Surgery, Ruijin Hospital Affiliated to School of Medicine, Shanghai Jiaotong University, Shanghai 200025, China |
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| Abstract: | Objective To evaluate the efficacy of precut over a pancreatic duct stent (PPDS) for difficult biliary cannulation in endoscopic retrograde cholangiopancreatography (ERCP). Methods A retrospective analysis was conducted on the clinical data of all patients underwent ERCP in Ruijin Hospital between Jun. 1 2016 and May 31 2021. According to the selected method during difficult biliary cannulation if guidewire entered pancreatic duct unintendedly, patients were divided into two groups: (1) PPDS group, (2) double-guidewire (DGW)/transpancreatic sphincterotomy (TPS) group. The success rate of biliary cannulation and ERCP-related complication between the two groups were compared. Results Among 880 ERCP, 85 patients were enrolled in this study, 37 patients in PPDS group, and 48 patients in DGW/TPS group. There was no statistical difference in age, sex, preoperative common bile duct diameter, serum total bilirubin, or etiology between the two groups (P>0.05). In PPDS group, 35 patients (94.6%, 35/37) had successful biliary cannulation; no post-ERCP pancreatitis (PEP), bleeding, perforation occurred in PPDS group. In DGW/TPS group, 40 patients (83.3%, 40/48) had successful biliary cannulation; 10 patients (20.8%, 10/48) had ERCP-related complications, with PEP in 9 patients, bleeding in 2 patients (1 patient had both PEP and bleeding), no perforation occurred. The success rate of biliary cannulation between the two groups had no significant difference (χ2=2.55, P=0.18), while the total ERCP-related complication incidence had significant difference (χ2=8.74, P=0.003). All patients were cured. Conclusion Precut over a pancreatic duct stent (PPDS) has high success rate of biliary cannulation, which can reduce ERCP-related complication incidence. PPDS is safe and simple. |
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| Keywords: | endoscopic retrograde cholangiopancreatography (ERCP) difficult biliary cannulation precut over a pancreatic duct stent double-guidewire transpancreatic sphincterotomy |
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