Genzlinger J L, McPhee M S, Fisher J K, Jacob K M, Helzberg J H
Department of Internal Medicine, St. Luke's Hospital of Kansas City, Missouri 64111, USA.
Am J Gastroenterol. 1999 May;94(5):1267-70. doi: 10.1111/j.1572-0241.1999.00996.x.
We designed a prospective study to determine the frequency of retroperitoneal air after endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy. We sought to elucidate the relationship of retroperitoneal air with endoscopic maneuvers, clinical findings, the length of sphincterotomy, and the time spent during the procedure. We also endeavored to determine the importance of retroperitoneal air and its most appropriate clinical management.
Twenty-one consecutive patients who had undergone ERCP with sphincterotomy had abdominal computed tomography (CT) examinations within 24 h after completion of the procedure. The CT findings were unknown to the clinicians, and none of the patients received postprocedural antibiotics.
Six (29%) of 21 patients exhibited CT findings of retroperitoneal air. All six patients had uneventful postprocedural courses, and none had abnormal clinical signs or symptoms. The occurrence of retroperitoneal air was not influenced by the presence of hyperamylasemia, the duration of the procedure, or the length of the sphincterotomy.
Retroperitoneal air is not an uncommon finding after ERCP with sphincterotomy. Moreover, the finding of retroperitoneal air in the absence of physical findings, is not a cause for alarm and does not require surgical intervention.
我们设计了一项前瞻性研究，以确定内镜逆行胰胆管造影术（ERCP）联合括约肌切开术后腹膜后积气的发生率。我们试图阐明腹膜后积气与内镜操作、临床发现、括约肌切开长度以及手术时间之间的关系。我们还努力确定腹膜后积气的重要性及其最合适的临床处理方法。
21例连续接受ERCP联合括约肌切开术的患者在术后24小时内接受腹部计算机断层扫描（CT）检查。临床医生不知道CT检查结果，且所有患者术后均未使用抗生素。
21例患者中有6例（29%）出现腹膜后积气的CT表现。所有6例患者术后过程均顺利，无一例有异常临床体征或症状。腹膜后积气的发生不受高淀粉酶血症、手术持续时间或括约肌切开长度的影响。
ERCP联合括约肌切开术后腹膜后积气并不罕见。此外，在没有体格检查异常的情况下发现腹膜后积气，无需惊慌，也不需要手术干预。
