Mandai Koichiro, Uno Koji, Fujii Yasutoshi, Kawamura Takuji, Yasuda Kenjiro
Department of Gastroenterology, Kyoto Second Red Cross Hospital, 355-5 Haruobi-cho, Kamigyo-ku, Kyoto 602-8026, Japan.
Gastroenterol Res Pract. 2017;2017:1515260. doi: 10.1155/2017/1515260. Epub 2017 Apr 12.
Several previous studies assessed the competence in endoscopic retrograde cholangiopancreatography (ERCP) using the bile duct cannulation success rate. However, the cannulation time is also important, because a long cannulation time was reported to be a risk factor for post-ERCP pancreatitis. To determine the number of ERCP procedures required for short cannulation time of the bile duct. We retrospectively analyzed 605 ERCP procedures performed for bile duct cannulation in patients with native papilla at our institution between March 2012 and December 2015. The successful procedures were divided into 2 groups: group L and group S (cannulation time > 15 minutes and ≤15 minutes, resp.). An analysis of the relationship among the biliary cannulation time, ERCP experience, and other factors was then conducted. Multivariate analysis showed that the ERCP experience of ≤300 procedures (odds ratio, 2.080; 95% confidence interval, 1.337-3.142; = 0.001) and malignant biliary stricture due to pancreatic cancer (odds ratio, 1.912; 95% confidence interval, 1.072-3.412; = 0.028) were found to be significantly associated with a cannulation time of >15 minutes. Our findings suggested that an ERCP experience of ≤300 procedures and malignant biliary stricture due to pancreatic cancer were associated with prolonged biliary cannulation time.
此前有多项研究使用胆管插管成功率来评估内镜逆行胰胆管造影术（ERCP）的操作能力。然而，插管时间也很重要，因为据报道较长的插管时间是ERCP术后胰腺炎的一个危险因素。为了确定实现胆管短时间插管所需的ERCP操作次数。我们回顾性分析了2012年3月至2015年12月期间在本机构为具有天然乳头的患者进行胆管插管的605例ERCP操作。成功的操作被分为两组：L组和S组（插管时间分别>15分钟和≤15分钟）。然后对胆管插管时间、ERCP经验及其他因素之间的关系进行分析。多因素分析显示，操作次数≤300例（比值比，2.080；95%置信区间，1.337 - 3.142；P = 0.001）以及胰腺癌导致的恶性胆管狭窄（比值比，1.912；95%置信区间，1.072 - 3.412；P = 0.028）与插管时间>15分钟显著相关。我们的研究结果表明，操作次数≤300例以及胰腺癌导致的恶性胆管狭窄与胆管插管时间延长有关。
