Department of Surgery, Bharatpur Hospital, Bharatpur, Chitwan, Nepal.
Department of Anaesthesiology, Bharatpur Hospital, Bharatpur, Chitwan, Nepal.
JNMA J Nepal Med Assoc. 2020 Sep 27;58(229):645-649. doi: 10.31729/jnma.5435.
Endoscopic retrograde cholangiopancreatography is one of the most frequently used treatment modality for various pancreatobiliary problems. Frequent complications of endoscopic retrograde cholangiopancreatography include pancreatitis, cholangitis, hemorrhage and perforation. This study was done to see the prevalence of post endoscopic retrograde cholangiopancreatography pancreatitis in patient aggressively hydrated with Ringer's Lactate solution.
A descriptive cross sectional study was carried out on patient undergoing endoscopic retrograde cholangiopancreatography at Bharatpur Hospital from June 2018 to August 2020. Ethical clearance was taken from Institutional Review Committee Bharatpur Hospital (reference number 16/076/77). The convenient sampling method was applied. Data were collected and analyzed in statistical package for the social sciences version 16. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data.
Pain abdomen was assessed using Visual Analogue Scale and it was found that 8.1% of patients (15 patients) complained of pain abdomen with visual analogue scale> 3. Serum amylase was sent only in those patients who complained of pain abdomen and only in three patients (1.6%) serum amylase was increased more than 3 times the upper limit of normal value suggestive of pancreatitis. All three patients who had pancreatitis had precut sphincterotomy.
In this study we found that incidence of pancreatitis slumped after aggressive hydration with Ringer's lactate solution and adjunct use of other prophylactic measures for prevention of post endoscopic retrograde cholangiopancreatography pancreatitis might yield further better results.
内镜逆行胰胆管造影术是治疗各种胰胆问题的最常用方法之一。内镜逆行胰胆管造影术的常见并发症包括胰腺炎、胆管炎、出血和穿孔。本研究旨在观察在使用林格氏乳酸盐溶液积极水化的患者中,内镜逆行胰胆管造影术后胰腺炎的发生率。
对 2018 年 6 月至 2020 年 8 月在巴哈特布尔医院接受内镜逆行胰胆管造影术的患者进行了描述性横断面研究。巴哈特布尔医院机构审查委员会(参考编号 16/076/77)已获得伦理批准。应用了便利抽样法。在统计软件包中收集和分析数据社会科学版 16. 计算了 95%置信区间的点估计值,以及二项数据的频率和比例。
使用视觉模拟量表评估腹痛,发现 8.1%的患者(15 例)诉腹痛,视觉模拟量表>3。只有那些诉腹痛的患者才会送检血清淀粉酶,只有 3 名患者(1.6%)的血清淀粉酶超过正常上限的 3 倍,提示胰腺炎。所有 3 例患有胰腺炎的患者均行预切开括约肌切开术。
在这项研究中,我们发现林格氏乳酸盐溶液积极水化并联合使用其他预防内镜逆行胰胆管造影术后胰腺炎的措施后,胰腺炎的发病率有所下降,进一步采取预防措施可能会取得更好的效果。