Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2020 Aug;83(8):733-736. doi: 10.1097/JCMA.0000000000000383.
For decades, endoscopic retrograde cholangiopancreatography (ERCP) has been widely performed as a diagnostic and therapeutic procedure for biliary and pancreatic diseases. Complications of ERCP include pancreatitis, hemorrhage, perforation, cholangitis, and cholecystitis. There are few studies that focus on the incidence of post-ERCP cholecystitis and its potential risk factors.
A retrospective single-center study was performed in 1345 ERCP procedures after excluding patients with current cholecystitis or post-cholecystectomy between January 2009 and December 2011. Potential risk factors for post-ERCP acute cholecystitis, including age, gender, biochemistry, imaging data, procedures such as endoscopic sphincterotomy (EPT), or endoscopic retrograde biliary drainage (ERBD), were obtained and analyzed by multivariate logistic regression analysis.
Cholecystitis developed after 13 (0.96%) of the 1345 ERCP procedures. Univariate and multivariate logistic regression analyses showed that cystic duct stones (odds ratio [OR] = 198.26; 95% CI, 5.12-7835.44) and ERBD (OR = 37.58; 95% CI, 3.25-445.56) were important potential risk factors for post-ERCP cholecystitis. The percentage of ERBD procedures and cystic duct stones in patients with post-ERCP cholecystitis was 76.9% and 39.8%, respectively. The 13 patients with post-ERCP cholecystitis all received antibiotics, and four of them also received percutaneous gallbladder drainage. All patients recovered without significant clinical event or mortality.
The incidence of post-ERCP cholecystitis was 0.96% in the 1345 ERCP procedures performed. Cyst duct stones and ERBD were found to be risk factors for post-ERCP cholecystitis.
几十年来，内镜逆行胰胆管造影术（ERCP）已广泛应用于胆道和胰腺疾病的诊断和治疗。ERCP 的并发症包括胰腺炎、出血、穿孔、胆管炎和胆囊炎。目前很少有研究关注 ERCP 后胆囊炎的发生率及其潜在的危险因素。
对 2009 年 1 月至 2011 年 12 月期间进行的 1345 例 ERCP 手术中，排除了当前患有胆囊炎或胆囊切除术后的患者，进行了一项回顾性单中心研究。获取并通过多变量逻辑回归分析，对 ERCP 后急性胆囊炎的潜在危险因素，包括年龄、性别、生化指标、影像学数据、内镜下括约肌切开术（EST）或内镜逆行胆管引流术（ERBD）等手术进行分析。
在 1345 例 ERCP 手术中，有 13 例（0.96%）发生了胆囊炎。单变量和多变量逻辑回归分析表明，胆囊管结石（比值比 [OR] = 198.26；95%CI，5.12-7835.44）和 ERBD（OR = 37.58；95%CI，3.25-445.56）是 ERCP 后胆囊炎的重要潜在危险因素。ERCP 后发生胆囊炎的患者中，ERBD 手术和胆囊管结石的比例分别为 76.9%和 39.8%。13 例 ERCP 后胆囊炎患者均接受了抗生素治疗，其中 4 例还接受了经皮胆囊引流。所有患者均康复，无明显临床事件或死亡。
在 1345 例 ERCP 手术中，ERCP 后胆囊炎的发生率为 0.96%。胆囊管结石和 ERBD 被认为是 ERCP 后胆囊炎的危险因素。
