摘要
目的探讨内镜下逆行胰胆管造影(endoscopic retrograde cholangiopancreatography,ERCP)术后十二指肠乳头出血与原发疾病的关系.方法回顾性分析温岭市第一人民医院收治的661例行治疗性ERCP术患者的临床资料.根据是否发生ERCP术后十二指肠乳头出血,分为出血组和未出血组,评价原发疾病类型与出血风险的关系.结果共纳入患者661例,其中40例发生出血,其总体发生率为6.1%.出血组患者合并高血压病发生率明显高于未出血组,差异有统计学意义(P<0.05).出血组壶腹部嵌顿结石、胆管癌、胰腺癌及十二指肠乳头癌的所占比率明显高于未出血组,差异有统计学意义(P<0.05).两组患者胆总管结石、急性化脓性胆管炎、急性胆源性胰腺炎及胆管炎性狭窄所占比率的比较无统计学差异(P>0.05).结论壶腹部嵌顿结石及恶性胆胰疾病ERCP术后十二指肠乳头出血的风险更大,重在预防出血,内镜止血安全有效.
AIM To investigate the relationship between postoperative duodenal papilla hemorrhage and primary disease in patients after therapeutic endoscopic retrograde cholangiopancreatography （ERCP）.The clinical data of 661 patients treated by ERCP at our hospital were retrospectively analyzed. According to whether the patients had postoperative duodenal papilla hemorrhage or not, they were divided into a bleeding group and a non-bleeding group. The relationship between primary disease type and the risk of bleeding was then evaluated.RESULTS The overall bleeding rate was 6.1% （40/661）. The percentage of patients with hypertension in the bleeding group was significantly higher than that in the non-bleeding group （P 〈 0.05）. The proportions of patients with impacted stones in the ampulla of Vater, bile duct carcinoma, pancreatic carcinoma and duodenal papilla carcinoma were significantly higher in the bleeding group than that in the non-bleeding group （P 〈 0.05）. The proportions of patients with common bile duct stones, acute suppurative cholangitis, acute biliary pancreatitis, and biliary cholangitis stricture in the two groups had no significant difference （P 〉 0.05）.CONCLUSION The risk of duodenal papilla bleeding after therapeutic ERCP is impacted stones in greater in patients with the ampulla of Vater, bile duct carcinoma, pancreatic carcinoma and duodenal papilla carcinoma. Prevention of bleeding should be emphasized in these patients, and endoscopic hemostasis is safe and effective.
作者
徐洪根
马进
Hong-Gen Xu Jin Ma(Department of Hepatobiliary Surgery, the First People＇s Hospital of Wenling, Wenling 317500, Zhejiang Province, China)
出处
《世界华人消化杂志》
CAS
2017年第8期755-759,共5页
World Chinese Journal of Digestology
关键词
内镜逆行胰胆管造影
治疗
并发症
十二指肠乳头出血
内镜止血
Endoscopic retrograde cholangiopancreatography
Treatment
Complica＇tion
Duodenal papilla hemorrhage
Endoscopic hemostasis
