Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan.
Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan ; School of Medicine, National Yang-Ming University, Taipei 112, Taiwan ; Department of Biological Sciences, National Sun Yat-sen University, Kaohsiung 804, Taiwan ; College of Pharmacy and Health Care, Tajen University, Pingtung 907, Taiwan.
Gastroenterol Res Pract. 2015;2015:575898. doi: 10.1155/2015/575898. Epub 2015 Apr 9.
Background. No study investigated the efficacy and safety of endoscopic papillary balloon dilation (EPBD) for the treatment of acute biliary pancreatitis (ABP). Method. We retrospectively reviewed the effects of EPBD on patients with ABP from February 2003 to December 2012. The general data, findings of image studies, details of the procedure, and outcomes after EPBD were analyzed. Result. Total 183 patients (male/female: 110/73) were enrolled. The mean age was 65.9 years. Among them, 155 patients had mild pancreatitis. The meantime from admission to EPBD was 3.3 days. Cholangiogram revealed filling defects inside the common bile duct (CBD) in 149 patients. The mean dilating balloon size was 10.5 mm and mean duration of the dilating procedure was 4.3 minutes. Overall, 124 patients had gross stones retrieved from CBD. Four (2.2%) adverse events and 2 (1.1%) intraprocedure bleeding incidents but no procedure-related mortality were noted. Bilirubin and amylase levels significantly decreased after EPBD. On average, patients resumed oral intake within 1.4 days. The clinical parameters and outcomes were similar in patients with different severity of pancreatitis. Conclusion. EPBD can be effective and safe for the treatment of ABP, even in patients presenting with severe disease.
目前尚无研究调查内镜下乳头气囊扩张术(EPBD)治疗急性胆源性胰腺炎(ABP)的疗效和安全性。
我们回顾性分析了 2003 年 2 月至 2012 年 12 月期间 EPBD 治疗 ABP 患者的疗效。分析了 EPBD 的一般资料、影像学检查结果、操作细节和 EPBD 后的结果。
共纳入 183 例患者(男/女:110/73)。患者的平均年龄为 65.9 岁。其中 155 例为轻症胰腺炎。从入院到 EPBD 的中位时间为 3.3 天。149 例胆管造影显示胆总管内有充盈缺损。扩张球囊的平均直径为 10.5mm,扩张时间平均为 4.3 分钟。总体而言,124 例患者从胆总管中取出了大结石。有 4 例(2.2%)发生不良事件,2 例(1.1%)发生术中出血,但无与操作相关的死亡病例。EPBD 后胆红素和淀粉酶水平显著降低。平均而言,患者在 1.4 天内恢复口服饮食。不同严重程度胰腺炎患者的临床参数和结局相似。
EPBD 治疗 ABP 有效且安全,即使在重症患者中也如此。