Department of Gastroenterology, Hitit University Erol Olcok Training and Research Hospital, Corum, Turkey.
Dig Dis Sci. 2021 Jun;66(6):1845-1851. doi: 10.1007/s10620-021-06940-4. Epub 2021 Mar 23.
Personal protective equipment (PPE) decreases the risk of disease contagion, and because of the COVID-19 pandemic, enhanced PPE (EPPE) is widely used during endoscopic procedures including endoscopic retrograde cholangiopancreatography (ERCP). The aim of this study was to investigate the effects of EPPE on ERCP success parameters compared to standard PPE (SPPE).
ERCP procedures were evaluated retrospectively and ERCP outcomes were compared for similar time periods as before and after the COVID-19 pandemic. Primary outcomes were cannulation time, number of cannulation attempts, cannulation success rate, difficult cannulation rate, undesired pancreatic duct cannulation rate, ERCP-related adverse events, and length of hospital stay.
Three hundred and eighty ERCP procedures were examined. One hundred and fifty-nine procedures were excluded due to missing data, previous sphincterotomy or altered anatomy. Of the final eligible sample size of 221 ERCPs, 93 were performed using SPPE and 128 were performed under EPPE. Indications of ERCP and demographic parameters were similar between groups. The majority of the ERCP cases included were for benign biliary obstruction of common bile duct stones (88.7%). No significant differences were detected in overall technical success (91.4% vs 92.2%, p = 0.832), cannulation success rates (94.6% vs 96.8%, p = 0.403), cannulation times (median times of both groups were 3 min, p = 0.824), difficult cannulation rates (37.6% vs 33.6%, p = 0.523), undesired pancreatic duct cannulation rates (29% vs 22.7%, p = 0.593), number of cannulation attempts (2.80 vs 2.71, p = 0.731), ERCP-related adverse events (9.7% vs 10.9%, p = 0.762), and length of hospital stay (6.63 vs 6.92 days, p = 0.768) between SPPE and EPPE groups, respectively.
Biliary obstructions of common bile duct stones were the major indication of ERCP in the current study. The use of EPPE had no negative effects on ERCP performance in this patient group. ERCP can be effectively performed under EPPE.
个人防护设备 (PPE) 可降低疾病传播的风险，由于 COVID-19 大流行，在包括内镜逆行胰胆管造影术 (ERCP) 在内的内镜检查中广泛使用增强型 PPE (EPPE)。本研究旨在探讨与标准 PPE (SPPE) 相比，EPPE 对 ERCP 成功参数的影响。
回顾性评估 ERCP 操作，并比较 COVID-19 大流行前后类似时间段的 ERCP 结果。主要结局是插管时间、插管尝试次数、插管成功率、困难插管率、非预期胰管插管率、与 ERCP 相关的不良事件和住院时间。
共检查了 380 例 ERCP 操作。由于数据缺失、先前的括约肌切开术或解剖改变，159 例操作被排除在外。在最终的 221 例符合条件的 ERCP 样本中，93 例使用 SPPE 进行，128 例在 EPPE 下进行。两组的 ERCP 适应证和人口统计学参数相似。大多数 ERCP 病例包括胆总管结石引起的良性胆道梗阻（88.7%）。总体技术成功率（91.4%与 92.2%，p=0.832）、插管成功率（94.6%与 96.8%，p=0.403）、插管时间（两组中位数均为 3 分钟，p=0.824）、困难插管率（37.6%与 33.6%，p=0.523）、非预期胰管插管率（29%与 22.7%，p=0.593）、插管次数（2.80 与 2.71，p=0.731）、与 ERCP 相关的不良事件（9.7%与 10.9%，p=0.762）和住院时间（6.63 与 6.92 天，p=0.768）在 SPPE 和 EPPE 组之间均无显著差异。
胆总管结石所致胆道梗阻是本研究中 ERCP 的主要适应证。在该患者人群中，使用 EPPE 对 ERCP 操作没有负面影响。ERCP 可以在 EPPE 下有效进行。
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