胰管支架置入在预防内镜逆行性胰胆管造影术后急性胰腺炎发生中的作用  

The role of preventive pancreatic duct stent placement in preventing acute pancreatitis after endoscopic retrograde cholangiopancreatography

作　　者：周巧直 刘天宇 隗永秋 董宁宁 郭俊峰 李鹏 冀明 牛应林 王拥军 张澍田 Zhou Qiaozhi;Liu Tianyu;Wei Yongqiu;Dong Ningning;Guo Junfeng;Li Peng;Ji Ming;Niu Yinglin;Wang Yongjun;Zhang Shutian(Department of Gastroenterology,Beijing Friendship Hospital,Capital Medical University,National Clinical Research Center for Digestive Diseases,Faculty of Gastroenterology of Capital Medical University,Beijing Key Laboratory for Precancerous Lesion of Digestive Diseases,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院消化内科国家消化系统疾病临床医学研究中心首都医科大学消化病学系消化疾病癌前病变北京市重点实验室,北京100050

出　　处：《中华预防医学杂志》2022年第7期990-993,共4页Chinese Journal of Preventive Medicine

摘　　要：为探讨胰管支架对内镜逆行性胰胆管造影(ERCP)术后预防急性胰腺炎(PEP)发生的作用,本研究回顾性分析2015年1月至2019年12月期间在首都医科大学附属北京友谊医院因胆总管结石首次行内镜逆行胰胆管造影患者的病例资料。根据术中是否留置胰管支架分为胰管支架组(147例)和未留置胰管支架组(192例)。以COTTON标准诊断是否发生内镜逆行性胰胆管造影术后急性胰腺炎,比较两组间急性胰腺炎的发生率。采用独立样本t检验、Pearson卡方检验(χ2)、Fisher精确检验方法比较组见差异。结果显示,胰管支架组有2例发生急性胰腺炎,均在48 h后好转。未留置胰管支架组有22例发生急性胰腺炎,其中20例在48 h好转,另2例为重症胰腺炎,经过30 d治疗后好转出院。胰管支架组(1.4%)和未留置胰管支架组(11.5%)之间急性胰腺炎发生率差异有统计学意义(χ2=12.905,P<0.001)。综上,胰管支架可能是预防ERCP术后发生PEP的有效方法。The aim of this study was to investigate the preventive effect of pancreatic duct stent on acute pancreatitis after endoscopic retrograde cholangiopancreatography.A retrospective analysis of the case data of patients who first underwent endoscopic retrograde cholangiopancreatography for choledocholithiasis in the Beijing Friendship Hospital from January 2015 to December 2019 for 5 years.According to whether the pancreatic duct stent was indwelled during the operation,they were divided into pancreatic duct stent group(147 cases)and non-indwelling pancreatic duct stent group(192 cases).The incidence of acute pancreatitis after endoscopic retrograde cholangiopancreatography was compared between the two groups according to COTTON criteria.Independent sample t test,Pearson Chi-square test(χ2)and Fisher′s exact test were used to compare groups′differences.There were 2 cases of acute pancreatitis in the pancreatic duct stent group,all of which improved after 48 hours.There were 22 cases of acute pancreatitis in the non-indwelling pancreatic duct stent group,of which 20 cases improved within 48 hours,and the other 2 cases had severe pancreatitis,which improved and discharged after 30 days of treatment.There was significant difference in the incidence of acute pancreatitis between the pancreatic duct stenting group(1.4%)and the group without placement of pancreatic duct stents(11.5%)(χ²=12.905,P<0.001).In conclusion,Pancreatic duct stent may be an effective method to prevent PEP.

关 键 词：胰管支架 内镜逆行性胰胆管造影 胰腺炎 

分 类 号：R657.51[医药卫生—外科学]