在Oddi括约肌局部应用硝酸甘油是否有助于内镜逆行胰胆管造影（ERCP）？一项双盲随机对照试验。
Does topical GTN on the sphincter of Oddi facilitate ERCP? A double-blind randomized control trial.
作者信息
Talwar A, Dare C, Pain J
机构信息
Department of General Surgery, Poole General Hospital, Longfleet Road, Dorset, BH15 2JB, United Kingdom.
出版信息
Surg Endosc. 2005 Jul;19(7):902-4. doi: 10.1007/s00464-004-9166-5. Epub 2005 May 4.
BACKGROUND
Endoscopic retrograde cholangio pancreatography (ERCP) is a technically challenging procedure. Glyceryl trinitrate (GTN) has been shown to reduce tone in the sphincter of Oddi (SO), cannulation of which is a rate-limiting factor. A double-blind randomized control trial was performed to assess whether topical GTN on the SO would facilitate cholangiography and/or bile duct cannulation.
METHODS
104 patients requiring ERCP for biliary symptoms were randomized into two groups, 52 controls pretreated with 5 ml 0.9% normal saline (NS) and 52 pretreated with 5 ml GTN (concentration 1 mg/ml).
RESULTS
There was no significant between the control group and the GTN group in primary cannulation rate (p = 0.76), time taken to cholangiography (p = 0.58), or time to cannulation (p = 0.43).
CONCLUSION
Topically administered GTN to the SO does not aid in obtaining a cholangiogram or cannulation during an ERCP.
背景
内镜逆行胰胆管造影术（ERCP）是一项技术要求较高的操作。已证实硝酸甘油（GTN）可降低Oddi括约肌（SO）的张力，而SO插管是一个限制因素。开展了一项双盲随机对照试验，以评估在SO局部应用GTN是否有助于胆管造影和/或胆管插管。
方法
104例因胆道症状需行ERCP的患者被随机分为两组，52例对照组患者预先给予5ml 0.9%生理盐水（NS），52例预先给予5ml GTN（浓度1mg/ml）。
结果
对照组和GTN组在首次插管率（p = 0.76）、胆管造影所需时间（p = 0.58）或插管时间（p = 0.43）方面无显著差异。
结论
在ERCP期间，对SO局部应用GTN无助于获得胆管造影图像或进行插管。
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