Sakai Yuji, Tsuyuguchi Toshio, Kumagai Junichiro, Ohyama Hiroshi, Nakada Taka-Aki, Ohtsuka Masayuki, Kato Naoya
Department of Gastroenterology, Sakai Clinic, Kimitsu, JPN.
Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, JPN.
Cureus. 2024 Aug 18;16(8):e67133. doi: 10.7759/cureus.67133. eCollection 2024 Aug.
Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (EST) are said to be useful procedures for gallstone pancreatitis. However, there have been few reports on a large number of patients to whom they were used. The clinical usefulness of ERCP and EST is herein examined retrospectively.
ERCP and EST were performed to evaluate their clinical usefulness and safety in 108 patients who had gallbladder stones from December 1985 to October 2017 and were diagnosed as having gallstone pancreatitis. Of 108 patients, 83 were mild, and 25 were severe. Following the procedures, clinical courses were observed for three years in 108 patients who underwent the treatments.
Cholangiogram was successfully conducted in 108 patients. Bile duct stones were noted in 90 patients, and the stones were removed after EST. Of 18 patients who did not show bile duct stone in cholangiogram, 13 patients underwent EST, while five patients taking anticoagulants completed procedures only with cholangiogram. Accidental symptom was hemorrhage in three patients (2.7%; 3/108), but it was mild and conservatively resolving. During the three-year observation period, acute cholangitis was noted in three patients (2.7%; 3/108), but no relapsing pancreatitis was noted.
It was suggested that ERCP and EST could be useful therapies for gallstone pancreatitis.
内镜逆行胰胆管造影术(ERCP)和内镜括约肌切开术(EST)据说是治疗胆石性胰腺炎的有效方法。然而,关于大量使用这些方法的患者的报道很少。本文对ERCP和EST的临床实用性进行了回顾性研究。
对1985年12月至2017年10月期间患有胆囊结石且被诊断为胆石性胰腺炎的108例患者进行ERCP和EST,以评估其临床实用性和安全性。108例患者中,83例为轻度,25例为重度。治疗后,对接受治疗的108例患者的临床病程进行了三年的观察。
108例患者均成功进行了胆管造影。90例患者发现胆管结石,EST后结石被取出。在胆管造影未显示胆管结石的18例患者中,13例接受了EST,5例服用抗凝剂的患者仅完成了胆管造影。意外症状为3例患者出血(2.7%;3/108),但症状较轻且保守治疗后缓解。在三年观察期内,3例患者出现急性胆管炎(2.7%;3/108),但未发现复发性胰腺炎。
提示ERCP和EST可能是治疗胆石性胰腺炎的有效疗法。