Department of Interventional Radiology, The Second Affiliated Hospital of Baotou Medical College, Baotou 014030, China.
Cell Biochem Biophys. 2011 Dec;61(3):473-9. doi: 10.1007/s12013-011-9230-4.
Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is one of the most common and serious complications of ERCP, which has become a major concern for digestive endoscopists. In the present study, we examine whether pancreatic duct stenting can reduce the incidence of PEP. Forty patients who underwent an ERCP in our hospital were selected according to their risk factors for PEP. They were randomly divided into two groups: (1) 20 subjects received a pancreatic duct stenting after ERCP to prevent pancreatitis (stent group, S); and (2) the other 20 subjects did not receive pancreatic duct stenting after ERCP (non-stent group, NS). Urine and serum amylase, and serum lipase were determined after the operation; symptoms of abdominal pain were monitored; cost of hospitalization was evaluated for the comparison. The results show that (1) 18 cases developed PEP, and they were significantly less in S group than in NS group (4 vs. 14 cases; P < 0.01); (2) Serum amylase was significantly lower in S group than in NS group (197.8 ± 339.7 vs. 825.4 ± 1253.4 U/l, respectively; P < 0.05); (3) The intensity of abdominal pain was 3.4 ± 0.8 in S group, compared to 4.1 ± 1.2 in NS group; (4) Duration of pharmaceutical treatment was not significantly different between the two groups (4.2 ± 1.4 vs. 6.1 ± 2.3 days, in S and NS group, respectively); and (5) The total hospitalization cost was significantly less in S group (8928 ± 2635 RMB) than in NS group (11288 ± 4325 RMB; P < 0.05). It is concluded that pancreatic duct stenting can reduce the incidence of PEP, shorten the duration of hospitalization, and therefore, lessen patients' financial burden. It is shown to be an effective way to prevent PEP.
内镜逆行胰胆管造影术后胰腺炎（PEP）是 ERCP 最常见和最严重的并发症之一，这已成为消化内镜医生关注的主要问题。在本研究中，我们研究了胰管支架置入是否可以降低 PEP 的发生率。根据 PEP 的风险因素，从我院接受 ERCP 的 40 名患者中选择了患者。他们被随机分为两组：（1）20 例 ERCP 后行胰管支架置入预防胰腺炎（支架组，S 组）；（2）20 例 ERCP 后不放置胰管支架（非支架组，NS 组）。术后检测尿和血清淀粉酶、血清脂肪酶；监测腹痛症状；评估住院费用进行比较。结果显示：（1）18 例发生 PEP，S 组明显少于 NS 组（4 例比 14 例；P<0.01）；（2）S 组血清淀粉酶明显低于 NS 组（197.8±339.7 vs. 825.4±1253.4 U/l，P<0.05）；（3）S 组腹痛强度为 3.4±0.8，NS 组为 4.1±1.2；（4）两组药物治疗持续时间无明显差异（S 组 4.2±1.4 天，NS 组 6.1±2.3 天）；（5）S 组总住院费用明显低于 NS 组（8928±2635 人民币元比 11288±4325 人民币元；P<0.05）。结论：胰管支架置入可降低 PEP 的发生率，缩短住院时间，从而减轻患者的经济负担。这是一种预防 PEP 的有效方法。
