经内镜逆行胰胆管造影术后并发急性胰腺炎的相关危险因素分析

目的分析经内镜逆行胰胆管造影(ERCP)并发急性胰腺炎的相关危险因素,以提高ERCP诊断及治疗水平,减少其发生率。方法回顾性分析了2003年6月至2007年7月于中国医科大学附属第一医院行诊断与治疗性ERCP的346例患者共399例次的临床资料。将患者按ERCP操作分为8组,比较各组术后24h血清淀粉酶及临床症状改变。结果399例次ERCP术后高淀粉酶血症发生率为12.5%(50/399),急性胰腺炎发生率为1.5%(6/399)。各组中高淀粉酶血症与急性胰腺炎发生率最高均为ERCP 胆管内支架组(分别为38.9%、11.1%)。399例次ERCP中,于2003年6月至2005年6月间进行153例次与2005年7月至2007年7月间进行的246例次比较,ERCP术后急性胰腺炎发生率分别为3.3%(5/153)、0.4%(1/246),差异有显著性意义。结论在ERCP操作中,胰管显影及术者经验是并发术后急性胰腺炎主要危险因素。

Analysis of the correlation risk factors for acute pancreatitis induced by ERCP

Objective To assess the related risk factors of endoscopic retrograde cholangiopancreatography(ERCP)on postoperative pancreatitis.To improve the level of diagnostic and therapeutic ERCP,to reduce the incidence of postoperative pancreatitis.Methods A total of 346 patients in our hospital referred to diagnostic and therapeutic ERCP(399 frequency)were divided into 8 groups;the differences of postoperative serum amylase in 24 hour as well as clinical symptoms were compared among different groups.Results The incidence of postoperative hyperamylasaemia was 12.5 %.The incidence of postoperative acute pancreatitis was 1.5 %.ERCP STENT therapeutic group(38.9%)had the highest incidence of postoperative hyperamylasaemia and postoperative acute pancreatitis among the groups.(respectively 38.9%,11.1%).There was the different incidence of postoperative actcte pancreatitis between the period from June 2003 to June 2005 and from July 2005 to July 2007,respectively 3.3%,0.4%.Conclusion Pancreatic duct contrast filling and deficient experience of doctor during ERCP manipulation are the main risk factors for postoperative pancreatitis.