急性胆源性胰腺炎伴非重度急性胆管炎患者延迟与早期内镜干预的结局比较。
Outcomes of delayed versus early endoscopic intervention for acute biliary pancreatitis with non-severe acute cholangitis.
机构信息
Department of Hepatobiliary Surgery, Dongyang People's Hospital, Affiliated Dongyang Hospital of Wenzhou Medical University, 60 West Wuning Road, Dongyang, 322100, Zhejiang, People's Republic of China.
School of Medicine, Shaoxing University, Shaoxing, 312000, Zhejiang, People's Republic of China.
出版信息
BMC Surg. 2022 Dec 26;22(1):440. doi: 10.1186/s12893-022-01890-8.
BACKGROUND
Despite previous studies on endoscopic interventions in patients with acute biliary pancreatitis (ABP), the optimal time to perform endoscopic retrograde cholangiopancreatography (ERCP) for ABP with non-severe acute cholangitis (AC) remains controversial.
METHODS
We performed a retrospective cohort analysis of patients with concurrent ABP and non-severe AC. The patients were divided into two groups: those who underwent ERCP ≤ 72 h after admission (early ERCP group) and those who underwent ERCP > 72 h after admission (delayed ERCP group). The primary outcomes were the technical success rate and ERCP-related complications.
RESULTS
The study involved 164 patients (early ERCP, n = 70; delayed ERCP, n = 94) who were treated from 1 December 2 to 2016 to 12 December 2021. The patients' baseline characteristics were not significantly different between the two groups. The technical success rate of ERCP was similar between the two groups (94.29% vs. 97.87%, p = 0.43). Morbidity was also similar between the two groups (p = 0.83). There was no significant difference in the total hospital stay (p = 0.13). However, the early ERCP group had a longer post-ERCP hospital stay (p < 0.001).
CONCLUSION
This retrospective analysis showed that delayed ERCP performed > 72 h after admission has economic and safety outcomes similar to those of early ERCP for patients with concurrent ABP and non-severe AC.
背景
尽管先前有研究探讨了内镜介入治疗急性胆源性胰腺炎（ABP）的相关问题，但对于非重度急性胆管炎（AC）的 ABP 患者，行内镜逆行胰胆管造影术（ERCP）的最佳时机仍存在争议。
方法
我们对同时患有 ABP 和非重度 AC 的患者进行了回顾性队列分析。将患者分为两组：入院后≤72 小时内行 ERCP（早期 ERCP 组）和入院后>72 小时内行 ERCP（延迟 ERCP 组）。主要结局是技术成功率和 ERCP 相关并发症。
结果
本研究纳入了 2016 年 12 月 2 日至 2021 年 12 月 12 日期间收治的 164 例患者（早期 ERCP 组，n=70；延迟 ERCP 组，n=94）。两组患者的基线特征无显著差异。两组 ERCP 的技术成功率相似（94.29% vs. 97.87%，p=0.43）。两组的发病率也相似（p=0.83）。总住院时间无显著差异（p=0.13）。但早期 ERCP 组的 ERCP 后住院时间更长（p<0.001）。
结论
这项回顾性分析表明，对于同时患有 ABP 和非重度 AC 的患者，入院后>72 小时行延迟 ERCP 的经济和安全结局与早期 ERCP 相似。
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