摘要
AIM： To evaluate whether an automatically controlled cut system （endocut mode） could reduce the complication rate of endoscopic sphincterotomy （EST） and serum hyperamylasemia after EST compared to the conventional blended cut mode. METHODS： From January 2001 to October 2003, 134 patients with choledocholithiasis were assigned to either endocut mode group or conventional blended cut mode group at the time of sphincterotomy. The two groups were retrospectively compared for the complications after EST and serum amylase level before and 24 h after the procedure. RESULTS： Of the 134 patients treated, 79 were assigned to conventional blended cut mode group and 55 to endocut mode group. There was no significant difference in age, sex, and serum amylase level before EST between the two groups. Complications were found in 5 patients of the endocut mode group （9%）： hyperamylasemia （5 times higher than normal） in 4 and moderate pancreatitis in 1. Complications were found in 13 patients of the conventional blended cut mode group （16%）： hyperamylasemia in 12 and moderate pancreatitis in 1. Serum amylase levels were elevated in both groups 24 h after EST （P〈0.02）. The average serum amylase level 24 h after EST in the conventional blended cut mode group was significantly higher than that in the endocut mode group （P〈 0.05）. CONCLUSION： Endocut mode offers a safety advantage over conventional blended cut mode for pancreatitis after EST by reducing hyperamylasemia.
瞄准：评估一个自动地控制的切割系统(endocut 模式) 是否能与常规混合切割模式相比在 EST 以后减少内视镜的括约肌切开术(EST ) 和浆液血淀粉酶过多的复杂并发症率。方法：从 2001 年 1 月到 2003 年 10 月，有胆总管石病的 134 个病人在括约肌切开术的时候被分到任何一个 endocut 模式组或常规混合切割模式组。二个组回顾地在 EST 和浆液淀粉酶以后为复杂并发症被比较水平在前和在过程以后的 24 h。结果：对待的 134 个病人， 79 被分到常规混合切割模式组， 55 组织到 endocut 模式。在年龄，性别，和在在二个组之间的 EST 前的浆液淀粉酶水平没有有效差量。复杂并发症在 endocut 模式组(9%) 的 5 个病人被发现：血淀粉酶过多(比正常高 5 倍) 在 4 并且在 1 的中等胰腺炎。复杂并发症在常规混合切割模式组(16%) 的 13 个病人被发现：在 12 的血淀粉酶过多和在 1 的中等胰腺炎。浆液淀粉酶层次在两个组被提高在 EST (P<0.02 ) 以后的 24 h。在在常规混合切割模式的 EST 以后的 24 h 组织的平均浆液淀粉酶水平在 endocut 模式组(P<0.05 ) 比那显著地高。结论：Endocut 模式由减少血淀粉酶过多在 EST 以后为胰腺炎在常规混合切割模式上提供一个安全优点。
