Jałocha Lukasz, Wojtuń Stanisław, Gil Jerzy
Wojskowy Instytut Medyczny w Warszawie, Klinika Gastroenterologii CSK MON.
Pol Merkur Lekarski. 2007 May;22(131):495-8.
Endoscopic procedures are considered to be a standard element of diagnosing establishing as well as curative measure undertaken in many illnesses of digestive tract. Common use of such potent tool means higher incidence of complications associated with such procedures. In order to qualify a patient to a proper procedure it is essential to reconsider the probability of complications and possibilities of its prevention. To evaluate the risk of the procedure the character of the possible complication and its frequency should be taken into account. Author presents the general complications which are independent of endoscopic procedure and the group of complications typical for a various kind of endoscopic procedures, which are closely related to the procedure. General complications are associated with preparation for the procedure, infections revealing as a result of the procedure and sedation. Specific complications, which are not related to the scale of the procedure, include perforations and bleedings. They are relatively common and might be dangerous, but unfortunately those complications result from improper qualification and preparation the patient to the procedure. Acute pancreatitis is one of the specific complications connected to ERCP. Because of the fact that the risk of this complication is very high the proper qualification of the patient to the procedure is crucial. Nowadays ERCP procedure is being used only in approved therapeutic procedure. This paper focus on basic enoscopic complications and their occurrence conditions. Special interest is placed upon prevention of various types of complications, especially those that incidence is higher in every day clinical practice.
内镜检查程序被认为是诊断以及对许多消化道疾病采取治疗措施的标准组成部分。这种强大工具的广泛使用意味着与此类程序相关的并发症发生率更高。为了使患者适合进行适当的程序,重新考虑并发症的可能性及其预防措施至关重要。为了评估该程序的风险,应考虑可能并发症的性质及其发生频率。作者介绍了与内镜检查程序无关的一般并发症以及各种内镜检查程序特有的并发症组,这些并发症与该程序密切相关。一般并发症与程序准备、因程序导致的感染以及镇静有关。与程序规模无关的特定并发症包括穿孔和出血。它们相对常见且可能很危险,但不幸的是,这些并发症是由于患者对程序的资格认定不当和准备不足所致。急性胰腺炎是与内镜逆行胰胆管造影(ERCP)相关的特定并发症之一。由于这种并发症的风险非常高,因此患者对该程序的适当资格认定至关重要。如今,ERCP程序仅用于经批准的治疗程序。本文重点关注基本的内镜并发症及其发生条件。特别关注各种类型并发症的预防,尤其是那些在日常临床实践中发生率较高的并发症。