年龄对内镜逆行胰胆管造影术后胰腺炎发病率及严重程度的影响。
The impact of age on the incidence and severity of post-endoscopic retrograde cholangiopancreatography pancreatitis.
作者信息
Katsinelos Panagiotis, Lazaraki Georgia, Chatzimavroudis Grigoris, Terzoudis Sotiris, Gatopoulou Anthi, Xanthis Andreas, Anastasiadis Sotiris, Anastasiadou Kiriaki, Georgakis Nikos, Tzivras Dimitris, Kountouras Jannis
机构信息
Department of Gastroenterology, 2 Clinic of Internal Medicine, School of Medicine, Aristotle University of Thessaloniki, Ippokration General Hospital (Panagiotis Katsinelos, Sotiris Terzoudis, Anthi Gatopoulou, Andreas Xanthis, Sotiris Anastasiadis, Kiriaki Anastasiadou, Nikos Georgakis, Dimitris Tzivras, Jannis Kountouras), Greece.
Department of Gastroenterology, Theagenion Anticancer Hospital (Georgia Lazaraki), Greece.
出版信息
Ann Gastroenterol. 2018 Jan-Feb;31(1):96-101. doi: 10.20524/aog.2018.0203. Epub 2017 Oct 18.
BACKGROUND
With advancing age there is progressive pancreatic atrophy and fibrosis, leading to tissue destruction and chronic pancreatitis that has been found to be protective against post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). However, there are no reports regarding the potential effect of the aging pancreatic changes on the incidence and severity of PEP. Therefore, the aim of the present study was to investigate the impact of senile changes in the pancreas on the incidence and severity of PEP.
METHODS
A total of 2688 patients who underwent the first therapeutic ERCP at a single center were included in the final analysis of the study. Patients were classified into two groups: 1644 patients aged ≤75 years (mean age 61.56+1.26 years), group A; and 1044 patients aged >75 years (mean age 81.97+4.29 years), group B. Patients' files were identified using a retrospective database linked to the endoscopy reporting system. Patients' characteristic, endoscopic findings, details of intervention and rate and severity of PEP were evaluated.
RESULTS
No significant differences between the two groups were observed with regard to ERCP indication, patient- and technique-related risk factors for PEP, presence of periampullary diverticulum, and type of therapeutic intervention. The incidence of PEP was 5.2% in group A and 4% in group B (P=NS) with comparable grades of severity. All episodes of pancreatitis had full recovery with conventional treatment. One death occurred from respiratory arrest in each group of patients.
CONCLUSION
This study shows that the pancreatic changes associated with aging do not influence the incidence and severity of PEP.
背景
随着年龄增长，胰腺会逐渐萎缩和纤维化，导致组织破坏和慢性胰腺炎，而慢性胰腺炎已被发现可预防内镜逆行胰胆管造影术（ERCP）后胰腺炎（PEP）。然而，关于胰腺老化变化对PEP发病率和严重程度的潜在影响尚无相关报道。因此，本研究的目的是探讨胰腺的衰老变化对PEP发病率和严重程度的影响。
方法
共有2688例在单一中心接受首次治疗性ERCP的患者纳入本研究的最终分析。患者分为两组：A组1644例年龄≤75岁（平均年龄61.56±1.26岁）；B组1044例年龄>75岁（平均年龄81.97±4.29岁）。通过与内镜报告系统相连的回顾性数据库识别患者档案。评估患者特征、内镜检查结果、干预细节以及PEP的发生率和严重程度。
结果
两组在ERCP适应证、与患者和技术相关的PEP危险因素、壶腹周围憩室的存在情况以及治疗性干预类型方面均未观察到显著差异。A组PEP的发生率为5.2%，B组为4%（P=无统计学意义），严重程度相当。所有胰腺炎发作经传统治疗后均完全康复。每组患者各有1例因呼吸骤停死亡。
结论
本研究表明，与衰老相关的胰腺变化不会影响PEP的发病率和严重程度。
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