内镜逆行胰胆管造影术后胰腺炎的危险因素和风险评估。
Risk Factors and Risk Assessment for Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis.
机构信息
Department of Gastroenterology, Nantong First People's Hospital, Affiliated Hospital 2 of Nantong University, Nantong, China.
出版信息
J Coll Physicians Surg Pak. 2024 Apr;34(4):413-418. doi: 10.29271/jcpsp.2024.04.413.
OBJECTIVE
To analyse the pertinent risk factors associated with post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) and develop a predictive scoring system for assessing the risk of PEP in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) procedures.
STUDY DESIGN
Descriptive study. Place and Duration of the Study: Department of Gastroenterology, Nantong First People's Hospital, Jiangsu, China, from January 2022 to January 2023.
METHODOLOGY
Clinical data of 375 patients who underwent successful ERCP treatment were collected and organised. Relevant risk factors for PEP were analysed, and a scoring system was established to predict the risk of PEP.
RESULTS
Among the 375 patients who underwent ERCP, the incidence of PEP was 9.07% (34/375). Univariate analysis revealed that female gender, pancreatic duct opacification, difficult cannulation, operation time ≥45 minutes, sphincter of Oddi dysfunction (SOD), and biliary stenting were risk factors for PEP. Multivariate analysis showed that female gender, pancreatic duct opacification, difficult cannulation, operation time ≥45 minutes, and SOD were independent risk factors for PEP. A scoring system was developed, and the receiver operating characteristic (ROC) curve analysis determined a cut-off value of 1.5 points. Patients with a score less than 1.5 points had a low probability of developing PEP, while those with a score greater than 1.5 points had a significantly higher probability of PEP.
CONCLUSION
Female gender, pancreatic duct opacification, difficult cannulation, operation time ≥45 minutes, and SOD were independent risk factors for PEP. Additionally, a reliable scoring system was established to predict the risk of PEP. Clinicians can use this scoring system to assess the risk of PEP in patients and implement preventive measures to reduce the incidence of PEP.
KEY WORDS
Endoscopic retrograde cholangiopancreatography, Post-ERCP pancreatitis, Risk factors, Risk assessment, Preventive measure.
目的
分析与内镜逆行胰胆管造影术后胰腺炎（PEP）相关的特定危险因素，并建立一种预测评分系统，以评估接受内镜逆行胰胆管造影术（ERCP）患者发生 PEP 的风险。
研究设计
描述性研究。地点和研究时间：中国江苏南通第一人民医院消化内科，2022 年 1 月至 2023 年 1 月。
方法
收集并整理了 375 例成功接受 ERCP 治疗的患者的临床资料。分析了 PEP 的相关危险因素，并建立了评分系统来预测 PEP 的风险。
结果
在 375 例接受 ERCP 的患者中，PEP 的发生率为 9.07%（34/375）。单因素分析显示，女性、胰管显影、插管困难、手术时间≥45 分钟、Oddi 括约肌功能障碍（SOD）和胆道支架置入是 PEP 的危险因素。多因素分析显示，女性、胰管显影、插管困难、手术时间≥45 分钟和 SOD 是 PEP 的独立危险因素。建立了评分系统，接收者操作特征（ROC）曲线分析确定了 1.5 分的截断值。评分小于 1.5 分的患者发生 PEP 的概率较低，而评分大于 1.5 分的患者发生 PEP 的概率显著较高。
结论
女性、胰管显影、插管困难、手术时间≥45 分钟和 SOD 是 PEP 的独立危险因素。此外，还建立了一种可靠的评分系统来预测 PEP 的风险。临床医生可以使用该评分系统评估患者发生 PEP 的风险，并采取预防措施降低 PEP 的发生率。
关键词
内镜逆行胰胆管造影术；内镜逆行胰胆管造影术后胰腺炎；危险因素；风险评估；预防措施。
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