胆道型Oddi括约肌功能障碍患者的ERCP术后胆道并发症(翻译)

时间:2018-08-07 作者:翻译:于廷廷 审校: 点击:
   
   
    摘要
    Oddi括约肌功能障碍(SOD)是ERCP术后胰腺炎的高危因素。胆管炎,绞痛和胆汁淤积引起的黄疸也会在ERCP术后出现。然而,这些ERCP术后胆道并发症尚未在SOD患者中得到充分评估。因此,我们对胆道型SOD的危险因素和ERCP术后胆道并发症进行评估。从1996年12月至2017年1月,筛选出72名被怀疑胆道型SOD的患者,其中60名进行ERCP手术的患者被纳入本研究。我们研究了胆道并发症的发生率以及与ERCP术后胆管炎相关的因素。 SOD组发生胆道疼痛和肝功能异常等胆道并发症的发生率高于对照组,特别是I型SOD患者。胆管直径≥12mm(26%,5/19)的患者ERCP术后胆管炎的发生率明显高于胆管直径<11 mm(2.4%,1/41; p = 0.016)的患者。年龄≥75岁也是ERCP术后胆管炎的危险因素(p = 0.013)。多变量分析证实,胆管直径≥12mm是ERCP术后胆管炎的重要危险因素。
    结论:术后ERCP胆道并发症常见于胆道型SOD,特别是I型。胆道直径≥12mm是ERCP术后胆管炎的重要危险因素。
   
 Post-ERCP biliary complications in patients with biliary type sphincter of Oddi dysfunction.
    Hiroyuki Miyatani, Hirosato Mashima, Masanari Sekine & Satohiro Matsumoto
                                                      Scientific REPORtS | (2018) 8:9951

Abstract
    Sphincter of Oddi dysfunction (SOD) has a high risk of post-ERCP pancreatitis. Cholangitis, colicky pain, and jaundice from cholestasis also occur after ERCP. However, these post-ERCP biliary complications have not been sufficiently evaluated in SOD. Thus, the risk factors and post-ERCP biliary complications in biliary-type SOD were evaluated. From December 1996 to January 2017, 72 patients with suspected biliary-type SOD were selected, and 60 patients who underwent ERCP were included in this study. The incidence of biliary complications compared to control group and factors associated with post-ERCP cholangitis were investigated. More frequent biliary complications, including biliary pain and abnormal liver function, occurred in SOD group than in control group, especially in type I SOD patients. Post-ERCP cholangitis occurred significantly more often with bile duct diameter ≥12 mm (26%, 5/19) than with bile duct diameter <11 mm (2.4%, 1/41; p = 0.016). Age ≥75 years was also a risk factor for post-ERCP cholangitis (p = 0.013). Multivariate analysis confirmed that bile duct diameter ≥12 mm was a significant risk factor for post-ERCP cholangitis. Post-ERCP biliary complications occurred frequently in biliary-type SOD, especially type I. Biliary diameter ≥12 mm was an important risk factor for post-ERCP cholangitis.

    翻译:于廷廷 审校:张立超、侯森林