Background: Endoscopic retrograde cholangiopancreatography(ERCP) may have complications. Our study aimed to investigate the risk factors and prevention of post-ERCP cholangitis.Methods: We retrospectively analyzed 423...Background: Endoscopic retrograde cholangiopancreatography(ERCP) may have complications. Our study aimed to investigate the risk factors and prevention of post-ERCP cholangitis.Methods: We retrospectively analyzed 4234 cases undergone ERCP in the Affiliated Drum Tower Hospital of Nanjing University Medical School from January 2008 to December 2013. Patient-related factors and procedure-related factors were analyzed to find the risk factors of post-ERCP cholangitis. The time point of post-ERCP cholangitis was also analyzed. Univariate and multivariate analyses were performed to define the independent risk factors of post-ERCP cholangitis.Results: The success rate of ERCP was 96.8%(4099/4234). The overall complication rate was 9.4%(399/4234). Post-ERCP cholangitis occurred in 102 cases(2.4%, 102/4234). The most dangerous time of post-ERCP cholangitis was from 24 h–48 h after ERCP(45.1%, 46/102). Univariate analysis revealed that age, hypertension, diabetes, previous ERCP history, biliary stent insertion, pancreatography, endoscopic sphincterotomy, balloon dilation and hilar obstruction were risk factors of post-ERCP cholangitis(P < 0.05). Multivariate analysis indicated that age, previous ERCP history and hilar obstruction were independent risk factors(P < 0.05). While endoscopic stone extraction was the potential protective factor.Conclusions: Many risk factors are involved in post-ERCP cholangitis. Among them, old age, previous ERCP history and hilar obstruction were independently related to this post-ERCP complication.展开更多
Over-the-scope clip(OTSC) system is becoming a new reliable technique which is available for the endoscopic closure of fistulas, bleeding, perforations and so on. We describe the case of a patient with a nonhealing ga...Over-the-scope clip(OTSC) system is becoming a new reliable technique which is available for the endoscopic closure of fistulas, bleeding, perforations and so on. We describe the case of a patient with a nonhealing gastrocutaneous fistula after esophagectomy for esophageal squamous cell carcinoma which was successfully closed using an OTSC system. This is the first report of the use of OTSC to treat a nonhealing gastrocutaneous fistula successfully after esophagectomy. We believe our experience will give such patients an ideal way to cure the fistula without suffering too much and also explore new application of OTSC.展开更多
基金supported by grants from the outstanding Youth Project of Nanjing Medical Scientific and Technological Development Project of Nanjing City(JQX14005)
文摘Background: Endoscopic retrograde cholangiopancreatography(ERCP) may have complications. Our study aimed to investigate the risk factors and prevention of post-ERCP cholangitis.Methods: We retrospectively analyzed 4234 cases undergone ERCP in the Affiliated Drum Tower Hospital of Nanjing University Medical School from January 2008 to December 2013. Patient-related factors and procedure-related factors were analyzed to find the risk factors of post-ERCP cholangitis. The time point of post-ERCP cholangitis was also analyzed. Univariate and multivariate analyses were performed to define the independent risk factors of post-ERCP cholangitis.Results: The success rate of ERCP was 96.8%(4099/4234). The overall complication rate was 9.4%(399/4234). Post-ERCP cholangitis occurred in 102 cases(2.4%, 102/4234). The most dangerous time of post-ERCP cholangitis was from 24 h–48 h after ERCP(45.1%, 46/102). Univariate analysis revealed that age, hypertension, diabetes, previous ERCP history, biliary stent insertion, pancreatography, endoscopic sphincterotomy, balloon dilation and hilar obstruction were risk factors of post-ERCP cholangitis(P < 0.05). Multivariate analysis indicated that age, previous ERCP history and hilar obstruction were independent risk factors(P < 0.05). While endoscopic stone extraction was the potential protective factor.Conclusions: Many risk factors are involved in post-ERCP cholangitis. Among them, old age, previous ERCP history and hilar obstruction were independently related to this post-ERCP complication.
基金Supported by National Natural Science Foundation of ChinaNo.81201908
文摘Over-the-scope clip(OTSC) system is becoming a new reliable technique which is available for the endoscopic closure of fistulas, bleeding, perforations and so on. We describe the case of a patient with a nonhealing gastrocutaneous fistula after esophagectomy for esophageal squamous cell carcinoma which was successfully closed using an OTSC system. This is the first report of the use of OTSC to treat a nonhealing gastrocutaneous fistula successfully after esophagectomy. We believe our experience will give such patients an ideal way to cure the fistula without suffering too much and also explore new application of OTSC.
