摘要
目的 研究不同时机置入胰管支架对双导丝法插管ERCP术后胰腺炎及高胰酶血症的影响。方法 选取该科2019年9月—2021年6月行双导丝法插管ERCP术的86例胆总管结石患者按照随机数字表法分为早期置入胰管支架组和晚期置入胰管支架组,每组43例。早期置入组在胆管插管成功后即沿胰管导丝置入胰管支架,移除胰管导丝后行十二指肠乳头切开(扩张)及取石,结石取尽后留置鼻胆管;晚期置入组在胆管插管成功后保留胰管导丝,先行十二指肠乳头切开(扩张)及取石,结石取尽后沿胰管导丝置入胰管支架,最后留置鼻胆管。统计并对比二组手术时间、术后胰腺炎、高胰酶血症、出血、消化道穿孔、住院时间等的差异。结果 二组手术时间、住院时间无统计学意义(P>0.05),早期置入组胰腺炎及高胰酶血症的发生率均低于晚期置入组,有统计学意义(P<0.05)。结论 对于双导丝法插管行ERCP取石的胆总管结石患者,早期置入胰管支架能更好地预防ERCP术后胰腺炎的发生。
Objective To study the effect of pancreatic duct stent implantation at different times on post-ERCP pancreatitis and hyperpancreatinemia.Methods From September 2019 to June 2021,eighty-six patients with choledocholithiasis who underwent double-guide-wire ERCP were randomly divided into two groups according to the random number table:early stent placement group and late stent placement group,43 in each group.In the early group,after successful biliary cannulation,the pancreatic duct stent was placed and zhe guidewire was removed.Then the duodenal papilla incision was performed and the stone were removed.In the late group,the pancreatic duct guidewire was retained after successful biliary cannulation.The duodenal papilla was incised and the stone were removed.The differences of Operation time,post-ERCP pancreatitis,hyperpancreatinemia,bleeding,digestive tract perforation and hospitalization time were compared between the two groups.Results There was no significant difference in operation time and hospital stay between the two groups(P>0.05).The incidence of pancreatitis and hyperpancreatinemia in the early implantation group was lower than that in the late implantation group(P<0.05).Conclusion Early placement of pancreatic stent can prevent the occurrence of post-ERCP pancreatitis for choledocholithiasis with double-wire intubation.
作者
刘昭明
许丙辉
齐双玉
姚皓
台剑熊
张青向
李恒力
鲍鸿斌
LIU Zhaoming;XU Binghui;QI Shuangyu;YAO Hao;TAI Jianxiong;ZHANG Qingxiang;LI Hengli;BAO Hongbin(Department of Hepatobiliary and Pancreatic Surgery,Harrison International Peace Hospital,HengShui 053000,China)
出处
《中国煤炭工业医学杂志》
2022年第3期251-255,共5页
Chinese Journal of Coal Industry Medicine
基金
河北省医学科学研究课题计划(编号:20200401)。
