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
Inflammatory bowel disease(IBD)is a systemic disorder affecting intestinal tract and other organs outside the gut,known as extraintestinal manifestations(EIMs).These EIMs are complex and diverse,and early treatment ma...Inflammatory bowel disease(IBD)is a systemic disorder affecting intestinal tract and other organs outside the gut,known as extraintestinal manifestations(EIMs).These EIMs are complex and diverse,and early treatment may reduce teratogenic rates and improve quality of life.However,our understanding of EIMs in IBD is currently limited by a lack of mechanistic insight.Fortunately,advances in our understanding of intestinal microecology are allowing us to uncover the underlying mechanisms of EIMs.The gut microbiota can drive aberrant immune activation and intestinal inflammation.Intriguingly,chronic inflammation can also shape the microbiome in reverse and aggravate dysbiosis.Recent research has revealed that microbiome-derived signal molecules play a crucial role in catalyzing enterocolitis and altering mucosal barrier function.Furthermore,gut microbiota-associated antigens can translocate from the intestine to extraintestinal sites,leading to systemic inflammatory responses.The microbiome is showing its potential in treating IBD and EIMs,and microbial engineering approaches,such as probiotic engineering and engineered fecal microbiota transplantation,are exhibiting great promise for IBD therapeutics.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 grant 2022-YXZX-XH-02 for Clinical Trials from the Affiliated Drum Tower HospitalMedical School of Nanjing University,and grant NDYG2022032 from Project of Chinese Hospital Reform and Development Institute,Nanjing UniversityAid Project of Nanjing Drum Tower Hospital Health,Education&Research Foundation.
文摘Inflammatory bowel disease(IBD)is a systemic disorder affecting intestinal tract and other organs outside the gut,known as extraintestinal manifestations(EIMs).These EIMs are complex and diverse,and early treatment may reduce teratogenic rates and improve quality of life.However,our understanding of EIMs in IBD is currently limited by a lack of mechanistic insight.Fortunately,advances in our understanding of intestinal microecology are allowing us to uncover the underlying mechanisms of EIMs.The gut microbiota can drive aberrant immune activation and intestinal inflammation.Intriguingly,chronic inflammation can also shape the microbiome in reverse and aggravate dysbiosis.Recent research has revealed that microbiome-derived signal molecules play a crucial role in catalyzing enterocolitis and altering mucosal barrier function.Furthermore,gut microbiota-associated antigens can translocate from the intestine to extraintestinal sites,leading to systemic inflammatory responses.The microbiome is showing its potential in treating IBD and EIMs,and microbial engineering approaches,such as probiotic engineering and engineered fecal microbiota transplantation,are exhibiting great promise for IBD therapeutics.
