Ishigaki Takashi, Sasaki Tamito, Serikawa Masahiro, Kobayashi Kenso, Kamigaki Michihiro, Minami Tomoyuki, Okazaki Akihito, Yukutake Masanobu, Ishii Yasutaka, Kosaka Keiichi, Mouri Teruo, Yoshimi Satoshi, Chayama Kazuaki
Hepatogastroenterology. 2015 Mar-Apr;62(138):417-24.
BACKGROUND/AIMS: The purpose of this study was to evaluate the relationship between prophylactic antibiotic use and complications following endoscopic retrograde cholangiopancreatography (ERCP).
We retrospectively evaluated 605 consecutive patients who underwent ERCP in our hospital between September 2009 and November 2011. The antibiotic group included patients who underwent their procedure before October 2010, while the control group included patients after October 1, 2010, who did not receive antibiotics. We compared the incidence of postoperative pancreatitis and cholangitis between the groups.
There were no significant differences in the backgrounds of the 304 control and the 301 antibiotic-treated patients. The incidence of post-ERCP pancreatitis was 4.9% in the control group and 4.3% in the antibiotic group (p = 0.72). The incidence of postoperative cholangitis was 2.0% in the control group and 1.7% in the antibiotic group (p = 0.99). Choledocholithiasis, pancreatic duct injection, and female gender were detected as significant risk factors for postoperative pancreatitis by multivariate analysis; sclerosing cholangitis and incomplete biliary drainage were significant risk factors for postoperative cholangitis. Even in cases with these risk factors, prophylactic antibiotic use did not influence the incidence of pancreatitis or cholangitis.
Prophylactic antibiotics do not reduce the incidence of either pancreatitis or cholangitis following ERCP.
背景/目的：本研究旨在评估内镜逆行胰胆管造影术（ERCP）后预防性使用抗生素与并发症之间的关系。
我们回顾性评估了2009年9月至2011年11月期间在我院连续接受ERCP的605例患者。抗生素组包括2010年10月之前接受手术的患者，而对照组包括2010年10月1日之后未接受抗生素治疗的患者。我们比较了两组术后胰腺炎和胆管炎的发生率。
304例对照组患者和301例接受抗生素治疗的患者在背景方面无显著差异。ERCP后胰腺炎的发生率在对照组中为4.9%，在抗生素组中为4.3%（p = 0.72）。术后胆管炎的发生率在对照组中为2.0%，在抗生素组中为1.7%（p = 0.99）。通过多因素分析，胆总管结石、胰管注射和女性被检测为术后胰腺炎的显著危险因素；硬化性胆管炎和不完全胆管引流是术后胆管炎的显著危险因素。即使在存在这些危险因素的病例中，预防性使用抗生素也不会影响胰腺炎或胆管炎的发生率。
预防性使用抗生素不会降低ERCP后胰腺炎或胆管炎的发生率。
