对连续546例胆石症患者行内镜括约肌切开术并发症的分析。
Analysis of complications of endoscopic sphincterotomy for biliary stones in a consecutive series of 546 patients.
作者信息
Coppola R, Riccioni M E, Ciletti S, Cosentino L, Coco C, Magistrelli P, Picciocchi A
机构信息
Department of General Surgery, Catholic University School of Medicine, Rome, Italy. Largo A. Gemelli 8. Rome 00168, Italy.
出版信息
Surg Endosc. 1997 Feb;11(2):129-32. doi: 10.1007/s004649900314.
BACKGROUND
Endoscopic sphincterotomy (ES) plays an important role in treatment of biliary stones; however, there remain some controversies concerning complications of ES, which in most cases seem not to be predictable.
METHODS
The aim of this study was a retrospective analysis of complications in 546 consecutive patients (267 males, 279 females, average age 63.7 years) who underwent endoscopic retrograde cholangiography (ERCP) for biliary stones from 1988 to 1995.
RESULTS
ES was performed in 535 patients (98%), and extraction of stones was successful in 493 (92%). In all, 29 complications (5.4%) were observed, including bleeding 13, cholangitis seven, cholecystitis four, pancreatitis three, retroduodenal perforation two; of these, four (14%) required an operation. Overall mortality was 0.3%.
CONCLUSION
While a significant decrease of the incidence of complications was observed in the course of the study, due to constantly improving experience, no correlation between risk factors and complications was identified.
背景
内镜括约肌切开术（ES）在胆石症治疗中发挥着重要作用；然而，关于ES的并发症仍存在一些争议，在大多数情况下这些并发症似乎无法预测。
方法
本研究旨在对1988年至1995年间因胆石症接受内镜逆行胆管造影（ERCP）的546例连续患者（男性267例，女性279例，平均年龄63.7岁）的并发症进行回顾性分析。
结果
535例患者（98%）接受了ES，493例（92%）结石取出成功。共观察到29例并发症（5.4%），包括出血13例、胆管炎7例、胆囊炎4例、胰腺炎3例、十二指肠后穿孔2例；其中4例（14%）需要手术治疗。总体死亡率为0.3%。
结论
虽然在研究过程中观察到并发症发生率显著下降，这得益于经验的不断积累，但未发现危险因素与并发症之间存在相关性。
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