针对内镜逆行胰胆管造影术后胰腺炎高风险患者的初次针刀括约肌切开术用于胆道通路建立
Primary Needle-Knife Sphincterotomy for Biliary Access in Patients at High Risk of Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis.
作者信息
Park Jin-Seok, Jeong Seok, Lee Don Haeng
机构信息
Division of Gastroenterology, Department of Internal Medicine, Inha University Hospital, Inha University College of Medicine, Incheon, Republic of Korea.
National Center of Efficacy Evaluation for the Development of Health Products Targeting Digestive Disorders (NCEED), Inha University Hospital, Incheon, Republic of Korea.
出版信息
Gastroenterol Res Pract. 2021 May 18;2021:6662000. doi: 10.1155/2021/6662000. eCollection 2021.
METHODS
Forty patients with one or more risk factors for PEP were prospectively enrolled between June 2018 and November 2019. The cannulation was conducted in all patients using NKS as the primary cannulation technique. Success rate of biliary cannulation, biliary cannulation time, and adverse event rate were assessed.
RESULTS
Of the 40 patients enrolled, 34 patients underwent primary NKS after the screening. Nine patients had 1 risk factor for PEP, 7 had 2, 8 had 3, 7 had 4, and 3 had 5. The success rate of biliary access by NKS was 94.1% (32/34). The median procedure time for NKS and the total procedure time for stone removal or biliary drainage were 4.1 minutes (range, 0.5-25.2) and 11.3 minutes (range, 3.8-40.4), respectively. Adverse events occurred in two patients (minor bleeding, = 1; hyperamylasemia, = 1). No patient experienced PEP or perforation.
CONCLUSION
NKS might be feasible as a primary cannulation procedure in patients at high risk of PEP. This trial is registered with KCT0004886 (03/06/2018).
方法
2018年6月至2019年11月期间，前瞻性纳入了40例具有一项或多项PEP风险因素的患者。所有患者均采用NKS作为主要插管技术进行插管。评估胆管插管成功率、胆管插管时间和不良事件发生率。
结果
在纳入的40例患者中，34例患者在筛查后接受了初次NKS。9例患者有1项PEP风险因素，7例有2项，8例有3项，7例有4项，3例有5项。NKS胆管通路成功率为94.1%（32/34）。NKS的中位操作时间和结石清除或胆管引流的总操作时间分别为4.1分钟（范围0.5 - 25.2）和11.3分钟（范围3.8 - 40.4）。2例患者发生不良事件（轻度出血1例；高淀粉酶血症1例）。无患者发生PEP或穿孔。
结论
对于PEP高危患者，NKS作为主要插管操作可能是可行的。本试验已在KCT0004886注册（2018年6月3日）。
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