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内镜逆行胰胆管造影术后胆管炎的危险因素。

Risk Factors for Post Endoscopic Retrograde Cholangiopancreatography Cholangitis.

作者信息

Boonsinsukh Thana, Viriyaroj Vichit, Yodying Hariruk

出版信息

J Med Assoc Thai. 2016 Nov;99 Suppl 8:S166-S170.

Abstract

BACKGROUND

Cholangitis is the one of complications in post endoscopic retrograde cholangiopancreatography (post- ERCP). Few studies investigated risk factors for post-ERCP cholangitis and the results showed different outcomes.

OBJECTIVE

The aim of the study was to determine the contributing risk factors for post-ERCP cholangitis.

MATERIAL AND METHOD

The medical records of patients who underwent ERCP from January 2013 to December 2015 were retrospectively reviewed. We excluded patients who had cholangitis before ERCP. All patients received intravenous prophylaxis antibiotic before the procedure. Demographic data, interested factors and result were collected. Univariate and multivariate analysis were used to identify risk factor for post-ERCP cholangitis.

RESULTS

227 patients enrolled where 204 (89.9%) of them were receiving therapeutic procedure. 156 (68.7%) patients were performed by high experience endoscopists (performing >50 ERCPs per year). The success rate was 87.7%. Post-ERCP cholangitis occurred in 20 (8.8%) patients as a result of therapeutic procedures. By univariate analysis, 8 variables were identified. They were male sex, age >60 year, no epigastric pain, albumin <2.5 gm/dL, bile duct cancer, common bile duct stones, change and remove bile duct stent. Multivariate analysis showed that age >60 year, albumin <2.5 gm/dL and remove bile duct stent were significantly associated with post-ERCP cholangitis.

CONCLUSION

Age >60 year, albumin <2.5 gm/dL and remove bile duct stent are three major risk factors for post-ERCP cholangitis.

摘要

背景

胆管炎是内镜逆行胰胆管造影术后(ERCP术后)的并发症之一。很少有研究调查ERCP术后胆管炎的危险因素,结果显示出不同的结果。

目的

本研究的目的是确定ERCP术后胆管炎的相关危险因素。

材料与方法

回顾性分析2013年1月至2015年12月接受ERCP的患者的病历。我们排除了ERCP术前患有胆管炎的患者。所有患者在手术前均接受静脉预防性抗生素治疗。收集人口统计学数据、相关因素和结果。采用单因素和多因素分析确定ERCP术后胆管炎的危险因素。

结果

共纳入227例患者,其中204例(89.9%)接受了治疗性操作。156例(68.7%)患者由经验丰富的内镜医师进行操作(每年进行>50例ERCP)。成功率为87.7%。20例(8.8%)患者因治疗性操作发生了ERCP术后胆管炎。单因素分析确定了8个变量。它们是男性、年龄>60岁、无中上腹疼痛、白蛋白<2.5 g/dL、胆管癌、胆总管结石、更换和取出胆管支架。多因素分析显示,年龄>60岁、白蛋白<2.5 g/dL和取出胆管支架与ERCP术后胆管炎显著相关。

结论

年龄>60岁、白蛋白<2.5 g/dL和取出胆管支架是ERCP术后胆管炎的三个主要危险因素。

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