ERCP插管操作模式改变的回顾性分析

目的 探讨逆行胰胆管造影(ERCP)插管操作模式的转变,对于ERCP的插管成功率、术后并发症发生率及操作时间的影响.方法 回顾分析2000年6月至2008年6月间因胆管疾病行诊治性ERCP的患者120例,其中选择常规插管法插管60例,使用导丝插管法插管60例.分别统计分析2组在ERCP操作过程中的目标管腔插管成功率、操作时间和术后7 d内的胰腺炎及感染发生情况.结果导丝插管组患者较常规插管组的插管成功率高(P<0.05).除外其他因素,与常规插管相比,采用导丝插管患者的操作时间缩短.常规插管组术后胰腺炎的发病率为10.0%(6/60),感染发生率为23.3%(14/60);导丝插管组术后胰腺炎的发病率为3.3%(2/60),感染发生率为10.0%(6/60).2组均未见出血并发症的发生.结论 ERCP中应用导丝进行目标管腔插管的操作模式,减少了操作的时间,显著提高了操作成功率,并降低了术后并发症发生率,但还需进一步具体研究.

A retrospective study of guide-wire assisted cannulation in endoscopic retrograde cholangiopancreatography

Objective To evaluate the influence of different cannulation technique in endoscopic retrograde cholangiopanereatography (ERCP) on success rate, risk of post-ERCP complication and operation time of the procedure. Methods The data of 120 patients who underwent ERCP from June 2000 to June 2008 because of biliary duct disorders were retrospectively studied. Conventional carmulation technique was applied in 60 patients and guide-wire eannulation was used in other 60. The success rate, total time of ERCP operation and the incidence of post-ERCP complications including acute pancreatitis and biliary system infec-tion within 7 days were assessed. Results Compared with conventional carmulation technique, selective can-nulation with a standard ERCP catheter under the assistance of guide-wire proved a higher success rate and a shorter operation time (P<0.05). Incidences of postoperative pancreatitis and infection with conventional cannulation were 10.0% (6/60) and 23.3% (14/60), respectively, while with guide-wire assisted cannu-lation were 3.3% (2/60) and 10.0% (6/60), respectively. No complication of bleeding was observed in either group. Conclusion Guide-wire assisted cannulation in ERCP can shorten operation time, improve success rate and reduce post-ERCP complications. Further evaluations are warranted.