Chiriac Stefan, Sfarti Catalin Victor, Stanciu Carol, Cojocariu Camelia, Zenovia Sebastian, Nastasa Robert, Trifan Anca
Department of Gastroenterology, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.
Institute of Gastroenterology and Hepatology, "St. Spiridon" Emergency Hospital, 700259 Iasi, Romania.
Life (Basel). 2023 Jun 19;13(6):1410. doi: 10.3390/life13061410.
Despite numerous advances that have aimed to increase the safety of endoscopic retrograde cholangiopancreatography (ERCP), post-ERCP pancreatitis (PEP) still remains a major issue. We aimed to assess the rate of PEP as well as the relation to the cannulation techniques in our unit, a high-volume center in north-eastern Romania.
ERCPs performed in our unit from March to August 2022 were retrospectively included. Data concerning demographic information, presence of difficult cannulation, the technique used for cannulation, as well as immediate complications, were gathered from the electronic database.
233 ERCPs were included. PEP was diagnosed in 23 (9.9%) of cases. Precut sphincterotomy (PS), transpancreatic sphincterotomy (TPBS), and a combination of TPBS and PS were performed in 6.4%, 10.3%, and 1.7% of cases, respectively, while an Erlangen precut papillotomy was performed in one case. Both in patients with PS and TPBS the rate of PEP was 20%. When the two techniques were associated, the rate of PEP was 25%. TPBS and PS represented risk factors for PEP (OR 1.211 for a CI of 0.946-1.551, = 0.041, and OR 1.124 for a CI of 0.928-1.361, = 0.088, respectively). No PEP-associated deaths were found.
Both PS and TPBS presented a similar risk of PEP.
尽管为提高内镜逆行胰胆管造影术（ERCP）的安全性已取得诸多进展，但ERCP术后胰腺炎（PEP）仍是一个主要问题。我们旨在评估我院（罗马尼亚东北部的一个大容量中心）的PEP发生率及其与插管技术的关系。
回顾性纳入2022年3月至8月在我院进行的ERCP病例。从电子数据库收集有关人口统计学信息、插管困难情况、所用插管技术以及即刻并发症的数据。
共纳入233例ERCP病例。23例（9.9%）被诊断为PEP。分别有6.4%、10.3%和1.7%的病例进行了预切开括约肌切开术（PS）、经胰括约肌切开术（TPBS）以及TPBS与PS联合手术，1例进行了埃尔朗根预切开乳头切开术。PS组和TPBS组的PEP发生率均为20%。当两种技术联合使用时，PEP发生率为25%。TPBS和PS是PEP的危险因素（OR分别为1.211，95%CI为0.946 - 1.551，P = 0.041；OR为1.124，95%CI为0.928 - 1.361，P = 0.088）。未发现与PEP相关的死亡病例。
PS和TPBS导致PEP的风险相似。
