两种预切开技术（经胰管括约肌切开术和针刀括约肌切开术）用于胆管插管的成功率和并发症发生率。
Success and complication rates of two precut techniques, transpancreatic sphincterotomy and needle-knife sphincterotomy for bile duct cannulation.
机构信息
Department of Gastroenterology, Changhai Hospital, Second Military Medical University, 168 Changhai Road, Shanghai 200433, China.
出版信息
J Gastrointest Surg. 2010 Apr;14(4):697-704. doi: 10.1007/s11605-009-1134-x.
BACKGROUND
The majority of literature on the precut technique is concerned with needle-knife sphincterotomy, whereas the comparison of transpancreatic sphincterotomy and needle-knife sphincterotomy has been rarely reported. Aim The aim of the study was to compare the success and the complication rates of transpancreatic sphincterotomy with needle-knife sphincterotomy.
METHODS
During May 2006 and April 2007, 3,178 consecutive endoscopic retrograde cholangiopancreatography (ERCP) procedures were performed in a prospective multicenter study on ERCP-related complications. From the files of these patients, data of cases undergoing precut sphincterotomy, including transpancreatic sphincterotomy and needle-knife sphincterotomy, were retrospectively extracted and analyzed.
RESULTS
Overall, 216 patients with precut sphincterotomy were identified; 140 cases received transpancreatic sphincterotomy, and 76 received needle-knife sphincterotomy. There was no significant difference in the initial and eventual success rates between transpancreatic and needle-knife sphincterotomy (82.9% vs. 90.8% and 90.0% vs. 90.8%, respectively). The overall incidences of complications and acute pancreatitis were not significantly different between the two groups (14.3% vs. 18.4% and 11.4% vs. 11.8%, respectively).
背景
大多数关于预切开技术的文献都集中在针刀括约肌切开术上，而关于经胰管括约肌切开术和针刀括约肌切开术的比较则很少有报道。目的：本研究旨在比较经胰管括约肌切开术和针刀括约肌切开术的成功率和并发症发生率。
方法
在 2006 年 5 月至 2007 年 4 月期间，在一项关于 ERCP 相关并发症的前瞻性多中心研究中，对 3178 例连续进行的内镜逆行胰胆管造影（ERCP）检查进行了研究。从这些患者的档案中，回顾性提取并分析了接受预切开括约肌切开术（包括经胰管括约肌切开术和针刀括约肌切开术）的病例数据。
结果
共有 216 例患者接受了预切开括约肌切开术，其中 140 例接受了经胰管括约肌切开术，76 例接受了针刀括约肌切开术。经胰管和针刀括约肌切开术的初始和最终成功率之间无显著差异（分别为 82.9%和 90.8%，90.0%和 90.8%）。两组患者的并发症和急性胰腺炎总发生率无显著差异（分别为 14.3%和 18.4%，11.4%和 11.8%）。
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