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经皮金属支架置入治疗恶性胆道梗阻后并发急性胰腺炎:一项回顾性的 2 中心研究。

Acute Pancreatitis After Percutaneous Metallic Stent Insertion for Malignant Biliary Obstruction: A Retrospective 2-Center Study.

机构信息

Department of Intervention Radiology, Suzhou Municipal Hospital Affiliated to Nanjing Medical University, Suzhou, China.

Department of Interventional Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

出版信息

Turk J Gastroenterol. 2023 Sep;34(9):961-967. doi: 10.5152/tjg.2023.22442.

Abstract

BACKGROUND/AIMS: The current study investigated the incidence, risk factors, and outcomes of acute pancreatitis after percutaneous transhepatic biliary stenting for malignant biliary obstruction.

MATERIALS AND METHODS

From March 2016 to May 2020, a total of 425 patients who underwent percutaneous transhepatic biliary stent- ing for malignant biliary obstruction were included in this 2-center study. After the procedure, we analyzed the incidence, risk factors, and outcomes of acute pancreatitis.

RESULTS

On follow-up, 79 (18.6%) patients showed increased serum amylase levels, of whom 41 (9.6%) developed pancreatitis. On binary logistic regression analysis, stent across the duodenal papilla (odds ratio = 8.54; 95% CI = 3.54-20.62; P < .001) and visualization of the pancreatic duct (odds ratio = 9.87; 95% CI = 4.67-20.86; P < .001) were significant risk factors of pancreatitis after the procedure. Using conservative therapy, all patients were successfully managed at a mean of 3.5 days (range 1-6 days), and no severe pancreatitis happened.

CONCLUSION

Acute pancreatitis is a relatively common complication after percutaneous transhepatic biliary stenting. Stent across the duodenal papilla and visualization of the pancreatic duct are independent risk factors.

摘要

背景/目的:本研究调查了经皮经肝胆道支架置入术治疗恶性胆道梗阻后急性胰腺炎的发生率、危险因素和结局。

材料和方法

本研究共纳入 2016 年 3 月至 2020 年 5 月期间在两个中心接受经皮经肝胆道支架置入术治疗恶性胆道梗阻的 425 例患者。术后,我们分析了急性胰腺炎的发生率、危险因素和结局。

结果

随访时,79 例(18.6%)患者血清淀粉酶水平升高,其中 41 例(9.6%)发生胰腺炎。二元逻辑回归分析显示,支架跨越十二指肠乳头(比值比=8.54;95%可信区间=3.54-20.62;P<0.001)和胰管显影(比值比=9.87;95%可信区间=4.67-20.86;P<0.001)是术后胰腺炎的显著危险因素。所有患者均采用保守治疗,平均 3.5 天(1-6 天)成功治愈,无严重胰腺炎发生。

结论

急性胰腺炎是经皮经肝胆道支架置入术后较常见的并发症。支架跨越十二指肠乳头和胰管显影是独立的危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9516/10544230/02dcd719a08f/tjg-34-9-961_f001.jpg

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