内镜下括约肌切开术治疗胆总管结石时，内切割模式的安全性优势。

Safety advantage of endocut mode over endoscopic sphincterotomy for choledocholithiasis.

作者信息

Akiho Hirotada, Sumida Yorinobu, Akahoshi Kazuya, Murata Atsuhiko, Ouchi Jiro, Motomura Yasuaki, Toyomasu Taisuke, Kimura Mitsuhide, Kubokawa Masaru, Matsumoto Masahiro, Endo Shingo, Nakamura Kazuhiko

机构信息

Division of Gastroenterology, Aso Iizuka Hospital, Japan.

出版信息

World J Gastroenterol. 2006 Apr 7;12(13):2086-8. doi: 10.3748/wjg.v12.i13.2086.

DOI:10.3748/wjg.v12.i13.2086

PMID:16610062

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4087690/

Abstract

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.

摘要

目的

评估与传统混合切割模式相比，自动控制切割系统（内镜下切割模式）能否降低内镜括约肌切开术（EST）的并发症发生率以及EST术后血清高淀粉酶血症的发生率。

方法

2001年1月至2003年10月，134例胆总管结石患者在括约肌切开术时被分为内镜下切割模式组或传统混合切割模式组。对两组EST术后的并发症以及手术前和术后24小时的血清淀粉酶水平进行回顾性比较。

结果

在接受治疗的134例患者中，79例被分配到传统混合切割模式组，55例被分配到内镜下切割模式组。两组患者的年龄、性别以及EST术前血清淀粉酶水平无显著差异。内镜下切割模式组有5例患者出现并发症（9%）：4例血清淀粉酶血症（高于正常水平5倍），1例中度胰腺炎。传统混合切割模式组有13例患者出现并发症（16%）：12例血清淀粉酶血症，1例中度胰腺炎。两组患者EST术后24小时血清淀粉酶水平均升高（P<0.02）。传统混合切割模式组EST术后24小时的平均血清淀粉酶水平显著高于内镜下切割模式组（P<0.05）。