Cozma Matei-Alexandru, Angelescu Cristina, Haidar Andrei, Mateescu Radu Bogdan, Diaconu Camelia Cristina
Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Department of Gastroenterology and Hepatology, Colentina Clinical Hospital, 020125 Bucharest, Romania.
Biomedicines. 2025 Mar 17;13(3):727. doi: 10.3390/biomedicines13030727.
: Pancreatitis is the most frequent and serious complication of endoscopic retrograde cholangiopancreatography (ERCP), with an incidence between 2 and 10% and a mortality rate of 1 in 500 patients. Etiopathogenesis remains poorly understood. The aim of this study was to analyze the incidence of post-ERCP pancreatitis (PEP) and to identify potential patient- and procedure-related risk factors (RF) in a cohort of patients from a tertiary referral center in Romania. : We conducted a retrospective, observational, single-center study in which we analyzed ERCP procedures performed in the Gastroenterology Department of Colentina Clinical Hospital, Bucharest, Romania, between January 2019 and September 2024. All patients received intrarectal diclofenac before the ERCP and were hydrated with at least 1500 mL of Ringer's solution after the procedure in the absence of contraindications, according to the latest international recommendations. : In total, 2743 ERCPs were performed in the given time period, while 2350 procedures were analyzed in the study. PEP occurred in 350 cases (14.9%). Of these, 191 (54.6%) occurred in males with a mean age of 66.5 years. Procedural RF with adjusted odds ratios (OR) were as follows: difficult cannulation of the common bile duct, OR = 3.734, < 0.001, main pancreatic duct catheterization, OR = 1.454, = 0.022, and endoscopic papillary balloon dilatation, with an OR of 3.258, < 0.001. Pancreatic duct stent placement was shown to prevent PEP in this study group ( < 0.001). : PEP remains a serious complication of ERCP, associated with significant morbidity and occasional mortality. While some proven risk factors, such as age, gender, or comorbidities, are unmodifiable, avoiding Wirsung duct cannulation and pancreatography, or prophylactic pancreatic duct stent placement, could play a significant role in PEP prevention.
胰腺炎是内镜逆行胰胆管造影术（ERCP）最常见且最严重的并发症，发病率在2%至10%之间，死亡率为每500例患者中有1例。其病因发病机制仍了解甚少。本研究的目的是分析ERCP术后胰腺炎（PEP）的发病率，并在罗马尼亚一家三级转诊中心的一组患者中确定潜在的患者及手术相关风险因素（RF）。
我们进行了一项回顾性、观察性单中心研究，分析了2019年1月至2024年9月期间在罗马尼亚布加勒斯特科伦蒂纳临床医院胃肠病科进行的ERCP手术。根据最新国际建议，所有患者在ERCP术前接受直肠双氯芬酸治疗，且在无禁忌症的情况下术后用至少1500毫升林格氏液进行水化。
在给定时间段内共进行了2743例ERCP手术，本研究分析了其中2350例手术。350例（14.9%）发生了PEP。其中，191例（54.6%）发生在男性患者中，平均年龄为66.5岁。调整后的比值比（OR）的手术相关风险因素如下：胆总管插管困难，OR = 3.734，P < 0.001；主胰管插管，OR = 1.454，P = 0.022；内镜下乳头球囊扩张术，OR为3.258，P < 0.001。本研究组显示胰管支架置入可预防PEP（P < 0.001）。
PEP仍然是ERCP的严重并发症，伴有显著的发病率和偶发的死亡率。虽然一些已证实的风险因素，如年龄、性别或合并症，是不可改变 的，但避免胰管插管和胰腺造影，或预防性胰管支架置入，可能在预防PEP中发挥重要作用。
