Lee Jae Joon, Lee Sung Koo, Kim Sang Hyung, Kim Ga Hee, Park Do Hyun, Lee Sangsoo, Seo Dongwan, Kim Myung-Hwan
Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Gut Liver. 2015 Sep 23;9(5):672-8. doi: 10.5009/gnl14217.
BACKGROUND/AIMS: Endoscopic therapy with endoscopic retrograde cholangiopancreatography (ERCP) has been suggested as an effective diagnostic and therapeutic tool for biliary and pancreatic disorders during pregnancy. In this report, we describe our experiences with pancreatobiliary endoscopic procedures during pregnancy.
We reviewed ERCP and endoscopic ultrasonography (EUS) procedures that were performed at a single tertiary care referral center between January 2002 and October 2013. Medical records were reviewed for the procedure indication, the duration of fluoroscopy, postprocedure complications, etc. Pregnancy outcomes and fetal complications were identified by chart review and phone calls to patients.
A total of 10 ERCPs and five EUSs were performed in 13 pregnant patients four of whom underwent the procedure in the first trimester, eight in the second trimester, and one in the third trimester. Indications for endoscopic therapy included gallstone pancreatitis, obstructive jaundice with common bile duct (CBD) stone, asymptomatic CBD stone, pancreatic cyst, choledochal cyst, and acute cholecystitis. Only one patient had a complication, which was postprocedural hyperamylasemia. Two patients underwent an artificial abortion, one according to her own decision and the other due to an adverse drug reaction.
ERCP seems to be effective and safe for pregnant women. Additionally, EUS can be an alternative to ERCP during pregnancy.
背景/目的：内镜逆行胰胆管造影术（ERCP）内镜治疗已被认为是孕期胆胰疾病有效的诊断和治疗工具。在本报告中，我们描述了孕期胰胆管内镜手术的经验。
我们回顾了2002年1月至2013年10月在单一三级医疗转诊中心进行的ERCP和内镜超声检查（EUS）手术。查阅病历以了解手术指征、透视时间、术后并发症等。通过查阅病历和致电患者确定妊娠结局和胎儿并发症。
13例孕妇共进行了10次ERCP和5次EUS，其中4例在孕早期进行手术，8例在孕中期进行，1例在孕晚期进行。内镜治疗的指征包括胆石性胰腺炎、胆总管（CBD）结石伴梗阻性黄疸、无症状CBD结石、胰腺囊肿、胆总管囊肿和急性胆囊炎。只有1例患者出现并发症，即术后高淀粉酶血症。2例患者进行了人工流产，1例是根据其自身决定，另1例是由于药物不良反应。
ERCP对孕妇似乎是有效且安全的。此外，EUS在孕期可作为ERCP的替代方法。
