Laohavichitra Kannikar, Akaraviputh Thawatchai, Methasate Asada, Leelakusolvong Somchai, Kachintorn Udom
Department of Surgery, Siriraj GI Endoscopy center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
World J Gastroenterol. 2007 Jul 21;13(27):3734-7. doi: 10.3748/wjg.v13.i27.3734.
To compare the results and complications of early pre-cutting technique with standard technique.
From January 2003 to December 2004, a total of 416 consecutive therapeutic biliary ERCP procedures were performed by one endoscopist (T.A.). Data were retrospectively collected according to procedure indication and results. Of these, 293 procedures (70.4%) were done with standard technique (group A) and 123 procedures (29.6%) with early pre-cutting technique in case of difficult cannulation (group B). The results and complications of ERCP were compared.
Success rate of first attempt cannulation was 98.0% in group A and 87.8% in group B. The overall incidence of post-ERCP pancreatitis, hemorrhage, perforation and cholangitis was 0%, 0.2%, 0.5% and 0.5%, respectively. Morbidity rate was not significantly different. No procedure-related mortality was occurred.
For an experienced hand, the early pre-cutting technique for biliary cannulation is safe and effective as standard technique.
比较早期预切开技术与标准技术的结果及并发症。
2003年1月至2004年12月，由一名内镜医师（T.A.）连续进行了416例治疗性胆管内镜逆行胰胆管造影（ERCP）手术。根据手术指征和结果回顾性收集数据。其中，293例手术（70.4%）采用标准技术（A组），123例手术（29.6%）在插管困难时采用早期预切开技术（B组）。比较ERCP的结果和并发症。
A组首次插管成功率为98.0%，B组为87.8%。ERCP术后胰腺炎、出血、穿孔和胆管炎的总发生率分别为0%、0.2%、0.5%和0.5%。发病率无显著差异。未发生与手术相关的死亡。
对于经验丰富的操作者，胆管插管的早期预切开技术与标准技术一样安全有效。
