Sagi Sashidhar V, Schmidt Suzette, Fogel Evan, Lehman Glen A, McHenry Lee, Sherman Stuart, Watkins James, Coté Gregory A
Department of Medicine, Division of Gastroenterology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
J Gastroenterol Hepatol. 2014 Jun;29(6):1316-20. doi: 10.1111/jgh.12511.
There are no data specifically correlating early intravenous volume infusion (IVI) with the length of hospitalization for postendoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP).
We conducted a retrospective cohort study of patients admitted within 24 h after ERCP to our institute with PEP. IVI during the first 24 h after ERCP was assessed. Primary outcome was severity of PEP, defined by length of hospitalization according to consensus guidelines: mild ≤ 3, moderate 4-10, and severe > 10 days.
Of 72 eligible patients, 41 (56.9%) had mild and 31 (43.1%) moderate/severe PEP. Both groups had comparable demographics, indications, and procedural factors except patients with moderate/severe PEP were older (median age 49 vs 36 years, P = 0.05) and more likely to be discharged and readmitted within the first 24 h (41.9% vs 14.6%, P < 0.01). Patients with mild PEP received significantly greater IVI during the first 24 h (2834 mL [2046, 3570] vs 2044 mL [1227, 2875], P < 0.02) and 50% more fluid post-ERCP (2270 mL [1435, 2961] vs 1515 [950-2350], P < 0.02) compared with those with at least moderate PEP.
In patients with PEP, greater IVI during the first 24 h after ERCP is associated with reduced length of hospitalization. Lower IVI was more commonly observed in individuals who were discharged and then readmitted during the first 24 h.
目前尚无专门数据表明内镜逆行胰胆管造影术(ERCP)后胰腺炎(PEP)早期静脉输液量(IVI)与住院时长之间的相关性。
我们对在我院因PEP于ERCP后24小时内入院的患者进行了一项回顾性队列研究。评估了ERCP后最初24小时内的静脉输液量。主要结局是PEP的严重程度,根据共识指南,依据住院时长定义:轻度≤3天,中度4 - 10天,重度>10天。
72例符合条件的患者中,41例(56.9%)为轻度PEP,31例(43.1%)为中度/重度PEP。两组在人口统计学、适应证和操作因素方面具有可比性,但中度/重度PEP患者年龄更大(中位年龄49岁对36岁,P = 0.05),且在最初24小时内更有可能出院后再入院(41.9%对14.6%,P < 0.01)。与至少中度PEP患者相比,轻度PEP患者在最初24小时内接受的静脉输液量显著更多(2834 mL [2046, 3570]对2044 mL [1227, 2875],P < 0.02),且ERCP后输液量多50%(2270 mL [1435, 2961]对1515 [950 - 2350],P < 0.02)。
在PEP患者中,ERCP后最初24小时内更多的静脉输液量与缩短住院时长相关。较低的静脉输液量更常见于在最初24小时内出院后再入院的患者。