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经内镜逆行胰胆管造影术(ERCP)并发症的发生率和淀粉酶敏感性对预测 ERCP 患者胰腺炎的作用。

Prevalence of Endoscopic Retrograde Cholangiopancreatography Complications and Amylase Sensitivity for Predicting Pancreatitis in ERCP Patients.

机构信息

Ahmad Hormati, MD, is Assistant Professor of Gastroenterology, Gastroenterology and Hepatology Disease Research Center, Qom University of Medical Sciences, Qom, Iran.

Faezeh Alemi, MD, is General Practitioner, Gastroenterology and Hepatology Disease Research Center, Qom University of Medical Sciences, Qom, Iran.

出版信息

Gastroenterol Nurs. 2020 Sep/Oct;43(5):350-354. doi: 10.1097/SGA.0000000000000473.

Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) is a complex procedure that is widely used for diagnosis and treatment of biliary and pancreatic diseases. With respect to its growing application, the present study aims to evaluate ERCP outcomes and complications. This cross-sectional study was performed using the data from 824 patients who underwent ERCP during 2014-2017 in Qom Shahid Beheshti hospital. Data were collected by a checklist and analyzed using SPSS V22. Among 824 patients, 397 (48.18%) were male and 427 (51.82%) were female with a mean age of 47 ± 6 years. The most common indications for ERCP were choledocholithiasis (78.28%) and cholestasis (20.27%), respectively. Total prevalence of complications was 15.66% and mortality rate was 0.72%. The most common complications were pancreatitis (9.59%) and bleeding (3.28%), respectively. A serum amylase level of greater than 160 could predict pancreatitis with sensitivity of 93.3% and specificity of 90.3%. Endoscopic retrograde cholangiopancreatography-related complications are inevitable but can be controlled by early diagnosis and clinical experience. Severe complications and high-risk patients may increase the mortality of the procedure.

摘要

经内镜逆行胰胆管造影术(ERCP)是一种广泛用于诊断和治疗胆道和胰腺疾病的复杂程序。鉴于其应用不断增加,本研究旨在评估 ERCP 的结果和并发症。这项横断面研究使用了 2014 年至 2017 年期间在库姆沙希德贝赫什提医院接受 ERCP 的 824 名患者的数据进行。数据通过检查表收集,并使用 SPSS V22 进行分析。在 824 名患者中,397 名(48.18%)为男性,427 名(51.82%)为女性,平均年龄为 47 ± 6 岁。ERCP 的最常见适应症分别为胆总管结石(78.28%)和胆汁淤积(20.27%)。并发症总发生率为 15.66%,死亡率为 0.72%。最常见的并发症分别为胰腺炎(9.59%)和出血(3.28%)。血清淀粉酶水平大于 160 可预测胰腺炎,其敏感性为 93.3%,特异性为 90.3%。内镜逆行胰胆管造影术相关并发症是不可避免的,但可以通过早期诊断和临床经验来控制。严重并发症和高危患者可能会增加该程序的死亡率。

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