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胆胰疾病患者内镜逆行胰胆管造影(ERCP)术后并发症的发生率及特征:一项回顾性研究

Prevalence and Characteristics of Post-endoscopic Retrograde Cholangiopancreatography (ERCP) Complications in Patients With Biliopancreatic Disorders: A Retrospective Study.

作者信息

Vallejo Romero Jose Luis, Cardenas Ramos Yazmin, Villegas Amador Floricel Olimpia, Barrueta Orive Sandra Allison, Aldana Carbajal Erick Mauricio, Ramirez Lugo Maria Guadalupe, Martinez Martinez Karen Andrea, Montiel Covarrubias Diana Laura, Nava Mata Luis Eduardo, Oliva Arvizu Alejandro Herbert

机构信息

Surgery, Regional General Hospital 1 of the Mexican Social Security Institute, Santiago de Querétaro, MEX.

General Practice, Regional General Hospital 1 of the Mexican Social Security Institute, Santiago de Querétaro, MEX.

出版信息

Cureus. 2025 Jul 10;17(7):e87673. doi: 10.7759/cureus.87673. eCollection 2025 Jul.

Abstract

OBJECTIVE

To determine the prevalence and clinical characteristics of post-endoscopic retrograde cholangiopancreatography (ERCP) complications, particularly acute pancreatitis, in patients with biliopancreatic disorders treated at a secondary-level referral hospital in Mexico between April 1, 2020, and December 31, 2023, and to compare outcomes between patients who received biliary stents and those who did not.

MATERIALS AND METHODS

This was an observational and retrospective study conducted at a secondary-level hospital in Mexico. A total of 151 medical records of patients who underwent ERCP were reviewed. Variables included sex, age, hyperamylasemia, hyperlipasemia, acute post-ERCP pancreatitis, and related complications.

RESULTS

The study included 151 patients, with a median age of 51 years and a predominance of female patients (60%, n = 90). Biliary stents were placed in 66% (n = 100), while 34% (n = 51) did not receive a stent. The most common indications for ERCP were choledocholithiasis (76%, n = 115), biliary stricture (11%, n = 16), suspected biliary tumor (4%, n = 6), and other causes (9%, n = 14). Post-ERCP pancreatitis, defined as abdominal pain following the procedure accompanied by elevated lipase and amylase levels, occurred in 4% (n = 4) of patients without a stent and 3.9% (n = 2) with a stent. Isolated hyperlipasemia and hyperamylasemia without clinical pancreatitis occurred in 11% (n = 17) and 8.6% (n = 13) of patients, respectively. Significant differences were observed in ERCP indications between groups: choledocholithiasis was more frequent in the non-stent group (90%, n = 90 of 100) compared to the stent group (49%, n = 25 of 51), whereas biliary strictures (25%, n = 13 of 51 vs. 3%, n = 3 of 100) and unresolved stones (80%, n = 41 of 51 vs. 25%, n = 25 of 100) were more common in the stented group (all p < 0.001).

CONCLUSION

The prevalence of post-ERCP pancreatitis was consistent with that reported in the international literature, with a higher incidence in women. ERCP continues to play a key role in the management of biliopancreatic diseases, underscoring the importance of ongoing research to enhance comprehensive care for the Mexican population.

摘要

目的

确定2020年4月1日至2023年12月31日在墨西哥一家二级转诊医院接受治疗的胆胰疾病患者内镜逆行胰胆管造影术(ERCP)后并发症的发生率和临床特征,尤其是急性胰腺炎,并比较接受胆管支架置入术和未接受该手术患者的治疗结果。

材料与方法

这是一项在墨西哥一家二级医院进行的观察性回顾性研究。共审查了151例接受ERCP的患者的病历。变量包括性别、年龄、高淀粉酶血症、高脂肪酶血症、ERCP术后急性胰腺炎及相关并发症。

结果

该研究纳入了151例患者,中位年龄为51岁,女性患者居多(60%,n = 90)。66%(n = 100)的患者置入了胆管支架,而34%(n = 51)的患者未接受支架置入。ERCP最常见的适应证是胆总管结石(76%,n = 115)、胆管狭窄(11%,n = 16)、疑似胆管肿瘤(4%,n = 6)和其他原因(9%,n = 14)。ERCP术后胰腺炎定义为术后出现腹痛并伴有脂肪酶和淀粉酶水平升高,未置入支架的患者中有4%(n = 4)发生,置入支架的患者中有3.9%(n = 2)发生。分别有11%(n = 17)和8.6%(n = 13)的患者出现孤立性高脂肪酶血症和高淀粉酶血症但无临床胰腺炎。两组之间在ERCP适应证方面存在显著差异:与支架组(49%,n = 25/51)相比,胆总管结石在未置入支架组中更常见(90%,n = 90/100),而胆管狭窄(25%,n = 13/51 vs. 3%,n = 3/100)和残留结石(80%,n = 41/51 vs. 25%,n = 25/100)在置入支架组中更常见(所有p < 0.001)。

结论

ERCP术后胰腺炎的发生率与国际文献报道一致,女性发病率更高。ERCP在胆胰疾病的治疗中继续发挥关键作用,这凸显了持续开展研究以加强对墨西哥人群综合护理的重要性。

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