ERCP 联合EST治疗与患者术后发生急性胰腺炎关系的Meta分析

目的探讨实施内镜逆行胰胆管造影术联合乳头括约肌切开术治疗与患者发生术后胰腺炎的关系。方法全面检索2013年7月以前公开发表的实施内镜逆行胰胆管造影术联合乳头括约肌切开术治疗与患者发生术后胰腺炎关系的文献，采用RevMan5．1．4版本软件对文献数据进行综合分析。结果检索并纳入关于实施内镜逆行胰胆管造影术联合乳头括约肌切开术治疗与患者发生术后胰腺炎关系的文献共11篇，患者共3294例，其中单纯内镜逆行胰胆管造影术组患者2181例，内镜逆行胰胆管造影术联合乳头括约肌切开术组患者1113例。实施内镜逆行胰胆管造影术联合乳头括约肌切开术治疗与单纯实施内镜逆行胰胆管造影术检查患者术后胰腺炎发生率的合并优势比为2．27[95％可信区间（1．11，4．65）]，P=0．03，差异有统计学意义。结论对患者实施内镜逆行胰胆管造影术联合乳头括约肌切开术治疗与单纯实施内镜逆行胰胆管造影术检查相比，前者术后发生术后胰腺炎的几率明显增大，应引起临床医师的重视。

Association Between the Therapeutic Method of ERCP Combined with EST and PEP: A Meta-Analysis

Objective To evaluate the relationship between the therapeutic method of endoscopic retrograde cholangiopancreatography （ERCP） combined with endoscopic sphincterotomy （EST） and post-ERCP pancreatitis （PEP）. Methods Studies involving the association between the therapeutic method of ERCP combined with EST and PEP published before July 2013 were evaluated by the quality evaluation criteria of Cochrane Handbook 5.0. Metaanalysis was done using software Review Manager （Version 5.1.4）. Results A total of 11 studies included 3 294 cases were identified （ERCP group of 2 181 patients; ERCP＋EST group of 1 113 patients）. The combined OR of incidence of PEP was 2.27 （95%CI 1.11-4.65）, P=0.03. Conclusion The incidence of PEP in ERCP＋EST group was significantly higher than the ERCP group, and more attention should be paid.