Mazen Jamal M, Yoon Eugene J, Saadi Altaf, Sy Theodore Y, Hashemzadeh Mehrtash
Division of Gastroenterology, Veterans Affairs (VA) Medical Center, Long Beach, CA 90822, USA.
Am J Gastroenterol. 2007 May;102(5):966-75. doi: 10.1111/j.1572-0241.2007.01127.x. Epub 2007 Mar 23.
To evaluate nationwide trends in the utilization of endoscopic retrograde cholangiopancreatography (ERCP) in relation to the advent of noninvasive methods of visualizing the biliary and pancreatic tree.
Retrospective cohort study. The Nationwide Inpatient Sample (NIS) database was used to calculate the age-adjusted rate for ERCPs performed from 1988 to 2002. The State Ambulatory Surgery Database (SASD) was used to evaluate trends in outpatient ERCPs from 1997 to 2003. Linear Poisson multivariate regression model was used to control for variations in age, gender, and ethnicity among the overall patient population.
The NIS database contained 402,343 patients who had an ERCP performed from 1988 to 2002. The mean age for these patients was 60.21 +/- 19.56 yr old. From 1988 to 1996; the age-adjusted rate for ERCPs increased by nearly threefold, from 25.66 per 100,000 in 1988 to 74.95 in 1996. The rate of 74.95 in 1996 declined to a rate of 59.70 by the year 2002. The rates of diagnostic ERCPs in men and women were 26.76 and 31.58 per 100,000 in 1988-1990, respectively. This rate then increased to 35.66 and 43.18 per 100,000 in 1994-1996, which then declined to 29.01 and 29.06 in 2000-2002. The age-adjusted rate for therapeutic ERCPs in men and women was 13.74 and 15.61 per 100,000 in 1988-1990, respectively, which continued to increase throughout the time span to 38.76 and 43.75 in 2000-2002. The SASD revealed a continual decline in outpatient ERCPs from 25.45 per 100,000 in 1997 down to 16.17 per 100,000 in the year 2003.
The utilization of ERCP dramatically increased from 1988 to 1996; however, since the advent of noninvasive diagnostic techniques such as endoscopic ultrasound (EUS) and magnetic resonance cholangiopancreatography (MRCP), there has been a steady decline in the utilization of diagnostic ERCPs from 1996 to 2002.
评估全国范围内内镜逆行胰胆管造影术（ERCP）的使用趋势，及其与胆道和胰腺可视化无创方法出现的关系。
回顾性队列研究。使用全国住院患者样本（NIS）数据库计算1988年至2002年进行ERCP的年龄调整率。使用州门诊手术数据库（SASD）评估1997年至2003年门诊ERCP的趋势。采用线性泊松多元回归模型控制总体患者人群中年龄、性别和种族的差异。
NIS数据库包含1988年至2002年期间进行ERCP的402343例患者。这些患者的平均年龄为60.21±19.56岁。1988年至1996年，ERCP的年龄调整率增加了近三倍，从1988年的每10万人25.66例增至1996年的74.95例。1996年的74.95例降至2002年的59.70例。1988 - 1990年男性和女性诊断性ERCP的发生率分别为每10万人26.76例和31.58例。该发生率随后在1994 - 1996年增至每10万人35.66例和43.18例，然后在2000 - 2002年降至29.01例和29.06例。1988 - 1990年男性和女性治疗性ERCP的年龄调整率分别为每10万人13.74例和15.61例，在整个时间段内持续上升，至2000 - 2002年分别为38.76例和43.75例。SASD显示门诊ERCP从1997年的每10万人25.45例持续下降至2003年的每10万人16.17例。
1988年至1996年期间ERCP的使用显著增加；然而，自内镜超声（EUS）和磁共振胰胆管造影（MRCP）等无创诊断技术出现以来，1996年至2002年诊断性ERCP的使用呈稳步下降趋势。
