冰水冷却乳头预防 ERCP 后胰腺炎（冰水挑战研究）。
Cooling the papilla with ice water in preventing post-ERCP pancreatitis (ice water challenge study).
机构信息
Department of Gastroenterology and Hepatology, Kitano Hospital, Tazuke Kofukai Medical Research Institute, 2-4-20 Ohgimachi, Kita-ku, Osaka, 530-8480, Japan.
Department of Gastroenterology and Hepatology, Rakuwakai Otowa Hospital, 2 Otowachinjicho Yamashina-ku, Kyoto, 607-8062, Japan.
出版信息
Surg Endosc. 2022 Aug;36(8):6002-6006. doi: 10.1007/s00464-021-08924-x. Epub 2022 Jan 3.
BACKGROUND
The most common adverse event of endoscopic retrograde cholangiopancreatography (ERCP) is post-ERCP pancreatitis (PEP). The aim of this study was to investigate the efficacy of cooling the papilla with iced water to reduce PEP.
PATIENTS AND METHODS
Between December 2018 and July 2019, 100 consecutive patients with native papilla undergoing ERCP were prospectively enrolled in this study. In all patients, iced water was injected endoscopically toward the papilla via the working channel at the end of ERCP. The results were compared with 100 previous cases with native papilla that underwent ERCP under the same conditions without papilla cooling.
RESULTS
Although the difference was not significant, the incidence of PEP tended to be lower in the study group (4%) than in the control group (11%) (p = 0.060). In addition, the incidence of PEP was significantly reduced in patients who underwent biliary sphincterotomy (p = 0.033). All cases of PEP were mild.
CONCLUSIONS
Cooling the papilla with iced water injection, which is safe, easy, and cheap might reduce PEP.
背景
内镜逆行胰胆管造影（ERCP）最常见的不良反应是内镜逆行胰胆管造影后胰腺炎（PEP）。本研究旨在探讨用冰水冷却乳头以降低 PEP 的疗效。
患者和方法
2018 年 12 月至 2019 年 7 月，前瞻性纳入 100 例接受 ERCP 的原发性乳头患者。在所有患者中，在 ERCP 结束时，通过工作通道将冰水经内镜注入乳头。结果与 100 例接受相同条件但未行乳头冷却的 ERCP 的原发性乳头的既往病例进行比较。
结果
虽然差异无统计学意义，但研究组（4%）的 PEP 发生率低于对照组（11%）（p=0.060）。此外，行胆管括约肌切开术的患者 PEP 发生率显著降低（p=0.033）。所有 PEP 病例均为轻度。
结论
用冰水注射冷却乳头，安全、简便、廉价，可能会降低 PEP 的发生率。
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