Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China.
Dig Dis Sci. 2013 Dec;58(12):3606-10. doi: 10.1007/s10620-013-2834-3. Epub 2013 Aug 24.
There is scarce information on whether performing the precut procedure early rather than after several cannulation attempts is associated with different success and complication rates.
The aim of this retrospective study was is to compare the early precut technique with the standard one in terms of the results and complications.
The contemporary success rate and postoperative complications in 792 endoscopic retrograde cholangiopancreatography cases were frequently observed during the period from June 2007 to May 2011, and 56 of these cases were carried out with precut biliary sphincterotomy after the standard sphincterotomy had failed.
The success rate for standard sphincterotomy was 89.8%: 51 out of 56 cases were carried out with precut biliary sphincterotomy and succeeded. The total success rate was 96.3%. The difference was significant (χ2=25.62, p<0.01) compared to the success rate of first cannulation, while the difference in complication rates between precut and standard sphincterotomy was minor (9.9 vs. 12.5%, p>0.05).
Early precut with a needle-knife in a difficult biliary cannulation was safe and effective if performed by experienced endoscopists.
目前关于在多次尝试插管后，是否尽早进行预切开术与不同的成功率和并发症发生率之间的关系，相关信息匮乏。
本回顾性研究旨在比较早期预切开术与标准术式在结果和并发症方面的差异。
2007 年 6 月至 2011 年 5 月期间，我们频繁观察了 792 例内镜逆行胰胆管造影术的当代成功率和术后并发症，其中 56 例在标准括约肌切开术失败后进行了预切开胆管括约肌切开术。
标准括约肌切开术的成功率为 89.8%：56 例中有 51 例采用预切开胆管括约肌切开术成功。总成功率为 96.3%。与首次插管成功率相比，差异有统计学意义（χ2=25.62，p<0.01），而预切开术与标准括约肌切开术的并发症发生率差异较小（9.9%比 12.5%，p>0.05）。
如果由经验丰富的内镜医生进行，在困难的胆管插管中使用针刀进行早期预切开是安全有效的。
