Instant duodenal decompression after endoscopic retrograde cholangiopancreatography can effectively reduce the incidence of post-ERCP pancreatitis and hyperamylasemia  

作　　者：Yu-Zhen Bi Si-Jia Yan Li-Min Zhou Yan Sun Jun Zhang 

机构地区：[1]Department of Gastroenterology,Chun’an Country First People’s Hospital(Zhejiang Provincial People’s Hospital,Chun’an Branch),Hangzhou,Zhejiang,P.R.China [2]Key Laboratory of Gastroenterology of Zhejiang Province,Zhejiang Provincial People’s Hospital(Affiliated People’s Hospital,Hangzhou Medical College),Hangzhou,Zhejiang,P.R.China [3]Department of Gastroenterology,The First Affiliated Hospital of Zhejiang Chinese Medical University(Zhejiang Provincial Hospital of Traditional Chinese Medicine),Hangzhou,Zhejiang,P.R.China

出　　处：《Gastroenterology Report》2024年第1期147-154,共8页胃肠病学报道(英文)

基　　金：Zhejiang Province Traditional Chinese Medicine Science and Technology Plan Project(No.2023ZL266).

摘　　要：Background:Post-ERCP pancreatitis(PEP)is significantly influenced by the reflux of duodenal fluid.While gastrointestinal decompression represents a fundamental approach in acute pancreatitis management,the effectiveness of immediate duodenal decompression following ERCP to prevent PEP remains uncertain.This study aimed to investigate the impact of immediate duodenal decompression after ERCP on reducing the incidence of hyperamylasemia and PEP.Methods:This retrospective study encompassed patients with native papilla who underwent therapeutic ERCP for choledocholithiasis at the Department of Gastroenterology,Chun’an Branch of Zhejiang Provincial People’s Hospital(Zhejiang,China)between January 2020 and June 2023.Based on the immediate placement of a duodenal decompression tube post-ERCP,patients were categorized into two groups:the duodenal decompression group and the conventional procedure group.Primary outcomes included the incidence of PEP and hyperamylasemia.Results:A total of 195 patients were enrolled(94 in the duodenal decompression group and 101 in the conventional procedure group).Baseline clinical and procedural characteristics exhibited no significant differences between the two groups.PEP occurred in 2 patients(2.1%)in the duodenal decompression group,in contrast to 11 patients(10.9%)in the conventional procedure group(Risk difference[RD]8.8%;95%confidence interval[CI]1.7%-16.5%,P=0.014).Hyperamylasemia was observed in 8 patients(8.5%)in the duodenal decompression group,compared to 20 patients(19.8%)in the conventional procedure group(RD 11.3%;95%CI 1.4%-21.0%;P=0.025).Patients with PEP in both groups showed improvement after receiving active treatment.No severe cases of PEP occurred in either group,and no serious adverse events related to duodenal catheter decompression were reported.Conclusion:Immediate duodenal decompression following ERCP demonstrates an effective reduction in the incidence of hyperamylasemia and PEP.

关 键 词：endoscopic retrograde cholangiopancreatography duodenal decompression post-ERCP pancreatitis HYPERAMYLASEMIA 

分 类 号：R57[医药卫生—消化系统]