胰管支架预防困难胆管插管ERCP术后急性胰腺炎的可行性及安全性探究

目的探讨置入胰管支架对内镜逆行性胰胆管造影术(endoscopic retrograde cholangio pancreatography,ERCP)术中胆管插管困难患者预防急性胰腺炎的效果。方法选取2016年10月~2017年7月我院收治的经ERCP术诊断产生胆管插管困难的患者114例,随机分为两组,对照组ERCP术中对胆管插管困难患者未置入胰管支架,研究组胆管插管困难患者于ERCP术中置入胰管支架。比较两组患者ERCP手术之后发生急性胰腺炎(acute pancreatitis,AP)并发症发生率,患者术后腹部疼痛状况以及治疗效果。结果研究组术后PEP的发生率显著低于对照组(P0.05),研究组ERCP术后患者腹部疼痛状况显著低于对照组(P0.05),术后研究组患者的治疗总有效率明显优于对照组(P0.05)。结论对ERCP术中胆管插管困难患者实施置入胰管,预防急性胰腺炎的效果比较理想,临床上应当进一步推广应用。

Investigation on the feasibility and safety of pancreatic duct stent in preventing acute pancreatitis after ERCP in the patients with difficult bile duct intubation during surgery

Objective To investigate the effect of implanted pancreatic duct stent in the prevention of acute pancreatitis in the patients with difficult bile duct intubation during endoscopic retrograde cholangio pancreatography(ERCP).Methods A total of 114 patients who were admitted to our hospital and were diagnosed with difficult bile duct intubation during ERCP from October 2016 to July 2017 were selected and were randomly divided into two groups.In the control group,patients with difficult bile duct intubation during ERCP were not implanted with the pancreatic duct stent.In the study group,the patients with difficult bile duct intubation during ERCP were implanted with the pancreatic duct stent.The incidence rate of AP complications after ERCP surgery,the postoperative abdominal pain,and the treatment effect were compared between the two groups.Results The incidence rate of postoperative PEP in the study group was significantly lower than that in the control group(P<0.05).Abdominal pain in the study group was significantly lower than that in the control group after ERCP(P<0.05).The total effective rate after the surgery in the study group was significantly better than that in the control group(P<0.05).Conclusion The effect of implantation of pancreatic duct in the patients with difficult bile duct intubation during ERCP is ideal for preventing acute pancreatitis.It should be further promoted and applied in clinical practice.