内镜逆行胰胆管造影术后胰腺炎的危险因素：日本一家地区医院的回顾性图表分析。

Risk Factors for Post-Endoscopic Retrograde Pancreatography Pancreatitis: A Retrospective Chart Review in a Regional Hospital in Japan.

机构信息

Internal Medicine, Karatsu Red Cross Hospital, Saga, Japan.

Department of Internal Medicine, Saga Medical School, Saga, Japan.

出版信息

Digestion. 2020;101(5):557-562. doi: 10.1159/000501309. Epub 2019 Sep 5.

DOI:10.1159/000501309

PMID:31487723

Abstract

BACKGROUND

Endoscopic retrograde pancreatography (ERCP) is sometimes complicated by post-ERCP pancreatitis (PEP), which is a severe adverse effect.

OBJECTIVE

The present study was performed to (i) evaluate the risk factors for PEP and (ii) compare the risk of PEP after ERCP performed in the off hours versus regular hours.

METHODS

This retrospective study included 374 patients who underwent ERCP from January 2013 to December 2017. Among these patients, 38 (10.2%) developed PEP. The potential risk factors for PEP were evaluated by multivariate regression analysis, and the risk of PEP was compared between ERCP performed during regular hours and off hours.

RESULTS

The independent risk factors for PEP were a relatively younger age (<75 years; p = 0.024), female sex (p = 0.002), a history of pancreatitis (p = 0.044), and performance of pancreatography (p = 0.010). Use of a diclofenac suppository and performance of pancreatic stenting were not preventive for PEP after ERCP. The complication rate of PEP did not differ between ERCP performed during the off hours versus regular hours.

CONCLUSIONS

A relatively younger age (<75 years), female sex, a history of pancreatitis, and performance of pancreatography were potential risk factors for PEP, whereas the risk of PEP was not different between ERCP performed during the off hours versus regular hours.

摘要

背景

内镜逆行胰胆管造影术（ERCP）有时会并发胰胆管造影术后胰腺炎（PEP），这是一种严重的不良事件。

目的

本研究旨在：（i）评估 PEP 的危险因素；（ii）比较 ERCP 在非工作时间与工作时间进行时 PEP 的风险。

方法

本回顾性研究纳入了 2013 年 1 月至 2017 年 12 月期间行 ERCP 的 374 例患者。其中 38 例（10.2%）发生了 PEP。通过多变量回归分析评估 PEP 的潜在危险因素，并比较 ERCP 在工作时间和非工作时间进行时 PEP 的风险。

结果

PEP 的独立危险因素为相对较年轻（<75 岁；p = 0.024）、女性（p = 0.002）、胰腺炎病史（p = 0.044）和胰管造影术（p = 0.010）。使用双氯芬酸栓剂和进行胰腺支架置入术并不能预防 ERCP 后 PEP。非工作时间与工作时间行 ERCP 时 PEP 的并发症发生率无差异。