Department of Gastroenterology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland.
Adv Med Sci. 2011;56(1):6-12. doi: 10.2478/v10039-011-0012-4.
Determination of the type and frequency of complications developing after diagnostic and therapeutic endoscopic retrograde cholangiopancreatography (ERCP) as well as the risk factors predisposing to them.
MATERIAL/METHODS: The retrospective study, including 734 ERCP performed in 550 patients, with 404 (55%) ES (endoscopic sphincterotomy) during a 4-year period.
Among 734 ERCP procedures, 76.4% (561) had both diagnostic and therapeutic purpose, 15.2% (112) were only diagnostic. Complications developed after 26 procedures (3.5%): acute pancreatitis (AP) in 8 patients (1.09%), cholangitis in 7 (0.95%) and delayed bleeding in 11 (1.5%) patients. After 49 (6.7%) ES immediate bleeding was observed. The risk factors for AP were: unintentional pancreatic duct contrasting, mechanical lithotripsy, the use of the "pre-cut" technique and bile duct dilatation. Cholangitis was more common in cases with difficult cannulation at older age and with lower baseline bilirubin level. The risk factors for delayed bleeding were: location of the ampulla of Vater in the diverticulum and the use of the "precut" technique. Immediate bleeding was more frequent after revision of bile ducts with Dormia's basket or with balloon, after introduction of contrast medium to the pancreatic duct or in ductal cholelithiasis.
ERCP performed in the endoscopy unit of a specialist hospital department is a relatively safe procedure, with a low burden of complications as compared to the benefits it provides to appropriately qualified patients.
确定在诊断和治疗性内镜逆行胰胆管造影（ERCP）后发生的并发症的类型和频率，以及导致这些并发症的危险因素。
材料/方法：这是一项回顾性研究，共纳入 550 例患者的 734 例 ERCP，其中 404 例（55%）在 4 年期间接受了内镜括约肌切开术（ES）。
在 734 例 ERCP 中，76.4%（561 例）具有诊断和治疗双重目的，15.2%（112 例）仅为诊断性。26 例（3.5%）出现并发症：8 例（1.09%）发生急性胰腺炎（AP），7 例（0.95%）发生胆管炎，11 例（1.5%）发生迟发性出血。49 例（6.7%）ES 后即刻发生出血。AP 的危险因素为：胰管意外对比、机械碎石、“预切开”技术的使用和胆管扩张。年龄较大、基线胆红素水平较低的患者更容易发生胆管炎。迟发性出血的危险因素为：壶腹 Vater 位于憩室内和“预切开”技术的使用。胆管再通时使用 Dormia 篮或球囊、向胰管内引入造影剂或存在胆管结石时，即刻出血更常见。
在专科医院内镜科进行的 ERCP 是一种相对安全的操作，与为合适的患者提供的益处相比，并发症负担较低。
