摘要
目的探讨经内镜逆行性胰胆管造影术(endoscopic retrograde pancreatic cholangio-pancreatography,ERCP)初学者在独立操作时胆总管下段角度与出现ERCP术后胰腺炎(post ercp pancreatitis,PEP)的关系.方法由初学者操作的ERCP手术病人65例,按胆总管下段与垂直线成角的角度分为小角度(≤30°,34例)及大角度(>30°,31例)两组.比较两组的插管时间,插入胰腺情况,术后高淀粉酶血症,PEP,术后出血等.结果小角度插管时间为(10.05±2.67)分钟、大角度为(9.35±2.79)分钟,小角度导丝入胰管概率为47.1%、大角度为32.2%,小角度术后高淀粉酶血症发生率为20.6%、大角度为19.4%,两组比较差异均无统计学意义.小角度PEP发生率为26.5%、大角度为3.22%,两组比较,差异有统计学意义(P<0.05).结论ERCP初学者独立操作时胆总管下段大角度病人出现术后胰腺炎的风险相对较低.
Objective To explore if the angle of distal common bile duct is the risk factors for PEP in beginner endoscopists without supervision.Methods We studied a retrospective analysis of 65 patients who were perfomed ERCP from the beginner endoscopists,Patients were Classified as acute(angle≤30°)and obtuse(angle>30°).The angle of the distal common bile duct(CBD)was measured as the angle between the lower wall of the bile duct and a vertical line on coronal view CT.Time of cannulation,The rate of pancreatic duct cannulation,Hyperamylasemia and PEP were compared between two groups.Results ERCP success rate was 91.1%in the acute angle group and 96.8%in the obtuse group.The cannulation time was angle group(10.05±2.67)min vs(9.35±2.79)min.The ratio of pancreatic duct cannulation was acute 50%than obtuse 32.2%angle group,Hyperamylasemia was acute 20.6%,obtuse 19.4%.The rate of PEP was acute(26.5%)than obtuse(3.22%)angle group(P=0.018).No other severe complications(bleeding and perforation)were happened(P<0.05).Conclusion Obtuse distal CBD angle may have lower risk of PEP when beginner endoscopists performing ERCP.
作者
李东哲
韩绍腾
隋春阳
张升瑞
LI Dongzhe;HAN Shaoteng;SUI Chunyang(Department of General Surgery,Afiliated Central Hospital of Shenyang Medical College,Shenyang 110000,China)
出处
《临床外科杂志》
2021年第7期627-629,共3页
Journal of Clinical Surgery
关键词
经内镜逆行性胰胆管造影术
内镜初学者
术后胰腺炎
endoscopic retrograde pancreatic cholangiopancreatography
beginner endoscopists
post ercp pancreatitis
