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首页> 外文期刊>Endoscopy International Open >Increased risk and severity of ERCP-related complications associated with asymptomatic common bile duct stones
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Increased risk and severity of ERCP-related complications associated with asymptomatic common bile duct stones

机译：与无症状胆总管结石相关的ERCP相关并发症的风险和严重性增加

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Background and study aims Endoscopic removal of asymptomatic common bile duct stones (CBDS) is generally recommended. Although many reports have described the risk of complications in endoscopic retrograde cholangiopancreatography (ERCP), no studies have addressed this problem in the context of asymptomatic CBDS.?This study examines the risk of complications arising in ERCP for asymptomatic CBDS. Patients and methods This retrospective study included 425 patients with naive papilla who underwent therapeutic ERCP for choledocholithiasis at 2 institutions in Japan for 2 years. The risk of complications was examined in patients who were divided into the asymptomatic and symptomatic CBDS groups. We used propensity score analysis to adjust for confounding effects. Results Complications were observed in 32 (7.5?%) of the 425 patients. Of the 358 patients with symptomatic CBDS, 14 patients (3.9?%) had complications. In contrast, of the 67 patients with asymptomatic CBDS, 18 patients (26.9?%) had complications. Propensity score analysis revealed that asymptomatic CBDS was a significant risk factor, with a significantly higher incidence of complications compared with symptomatic CBDS (odds ratio, 5.3). Moderate to severe complications were observed in 15 of 18 patients (83.3?%) in the asymptomatic CBDS group, with significantly more moderate to severe complications than those in the symptomatic CBDS (odds ratio, 6.7). Conclusions Asymptomatic CBDS carried a high risk of ERCP-related complications, and these were often more severe. In asymptomatic CBDS, endoscopic treatment should be carefully performed after considering the patient’s background, and detailed explanation of its possible complications should be given to patients in advance.
机译：背景和研究目的一般建议内镜下去除无症状的胆总管结石（CBDS）。尽管有许多报道描述了内镜逆行胰胆管造影术（ERCP）发生并发症的风险，但无症状的CBDS尚无研究解决该问题。患者和方法这项回顾性研究纳入了425例幼稚的乳头状瘤患者，他们在日本2家机构接受了ERCP治疗胆总管结石的治疗，为期2年。分为无症状和有症状的CBDS组的患者检查了并发症的风险。我们使用倾向得分分析来调整混杂效应。结果425例患者中有32例（7.5％）发生并发症。在358例有症状的CBDS患者中，有14例（3.9％）出现并发症。相反，在67例无症状的CBDS患者中，有18例（26.9％）出现并发症。倾向得分分析显示，无症状的CBDS是重要的危险因素，与有症状的CBDS相比，并发症的发生率显着更高（优势比，5.3）。无症状CBDS组的18例患者中有15例出现中度至重度并发症（占83.3％），中度至重度并发症的发生率明显高于有症状CBDS组（优势比为6.7）。结论无症状的CBDS患ERCP相关并发症的风险较高，而且通常更为严重。对于无症状的CBDS，应在考虑患者的背景后仔细进行内镜治疗，并应事先向患者详细解释其可能的并发症。

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