经内镜逆行胰胆管造影术后胆囊炎：前瞻性多中心胆胰内镜注册研究的发生率、特征和结局。
Post-ERCP cholecystitis: Incidence, characteristics, and outcomes from a prospective multicenter biliary endoscopy registry.
机构信息
Division of Gastroenterology, University of Toronto, Toronto, Ontario, Canada.
Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
出版信息
Gastrointest Endosc. 2024 Apr;99(4):633-640. doi: 10.1016/j.gie.2023.12.010. Epub 2023 Dec 11.
BACKGROUND AND AIMS
The incidence, risk factors, and outcomes of post-ERCP cholecystitis are poorly described. We aimed to describe cases of post-ERCP cholecystitis from a prospective multicenter registry with protocolized 30-day follow-up.
METHODS
Patient- and procedure-related data from 7 centers were obtained. The primary outcome was post-ERCP cholecystitis, defined according to a Delphi-based criteria and causal attribution system. Risk factors and outcomes were described for all cases.
RESULTS
Seventeen cases of post-ERCP cholecystitis were identified among 4428 patients with gallbladders undergoing ERCP between 2018 and 2023 (incidence, 0.38%; 95% confidence interval, 0.20-0.57). In ERCPs with covered metal stenting, 7 of 467 resulted in cholecystitis (incidence, 1.50%; 95% confidence interval, 0.40-2.60). Patients had symptoms at a median of 5 days (interquartile range, 5) after ERCP. Management strategies included cholecystectomy, percutaneous cholecystostomy, and endoscopic stent removal/exchange.
CONCLUSIONS
Estimates of post-ERCP cholecystitis incidence can inform discussions around procedural risk.
背景与目的
经内镜逆行胰胆管造影术（ERCP）后胆囊炎的发生率、危险因素和结局描述得并不完善。我们旨在通过前瞻性多中心登记研究，对接受 ERCP 检查的患者进行 30 天随访，描述基于协议的 ERCP 后胆囊炎病例。
方法
从 7 家中心获得患者和手术相关数据。主要结局为根据基于德尔菲共识的标准和因果归因系统定义的 ERCP 后胆囊炎。对所有病例进行危险因素和结局描述。
结果
2018 年至 2023 年期间，对 4428 例接受 ERCP 检查的胆囊患者中，有 17 例发生 ERCP 后胆囊炎（发生率为 0.38%；95%置信区间，0.20-0.57）。在接受覆盖金属支架的 ERCP 中，467 例中有 7 例发生胆囊炎（发生率为 1.50%；95%置信区间，0.40-2.60）。患者在 ERCP 后中位 5 天（四分位间距，5）出现症状。管理策略包括胆囊切除术、经皮胆囊造口术和内镜支架取出/更换。
结论
ERCP 后胆囊炎的发生率估计可以为手术风险的讨论提供依据。
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