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。
