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首页> 外文期刊>Diagnostic and therapeutic endoscopy >Preventive Role of Wire-Guided Cannulation to Reduce Hyperamylasemia and Pancreatitis Following Endoscopic Retrograde Cholangiopancreatography
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Preventive Role of Wire-Guided Cannulation to Reduce Hyperamylasemia and Pancreatitis Following Endoscopic Retrograde Cholangiopancreatography

机译：内镜下逆行胰胆管造影后，引导输注套管对减少高淀粉血症和胰腺炎的预防作用

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Background and Study Aims.The usefulness of wire-guided cannulation for avoiding hyperamylasemia and pancreatitis following endoscopic retrograde cholangiopancreatography (ERCP) is conflicting, and therefore we designed this study to determine whether wire-guided cannulation reduces the rate of post-ERCP hyperamylasemia and pancreatitis and compare its efficacy to conventional method.Patients and Methods.Seven hundred and forty-eight patients with hepatobiliary diseases consecutively underwent diagnostic or therapeutic ERCP at the unit of Taleghani referral hospital in Tehran. Among them, 546 patients were eligible for wire-guided cannulation and underwent this procedure and others underwent sphincterotome biliary cannulation using contrast injection as the conventional method.Results.Patients in the two groups were comparable in terms of gender and age. Successful biliary cannulation was achieved similary in the guidewire and conventional group (89.2% versus 86.4%) that in 5.4% and 14.1% of them it was difficultly performed, respectively (P=0.003). The main pancreatic duct was more visualized in 99.0% of patients in conventional group in comparison with 79.0% in another group (P<0.001). Multivariate regression analysis showed that wire-guided cannulation had a protective role for post-ERCP hyperamylasemia (OR: 0.336, 95% CI: 0.181–0.623,P<0.001). However, there were no significant differences between the two groups in rates of other procedure-related complications, such as, pancreatitis, bleeding, and perforation.Conclusion.The use of guidewire cannulation in comparison with conventional method can be accompanied with lower post-ERCP hyperamylasemia, and therefore selection of this cannulation technique especially in high-risk group is recommended.
机译：背景和研究目的：内镜逆行胰胆管造影（ERCP）后使用导线导管插管避免高淀粉血症和胰腺炎的作用是相互矛盾的，因此我们设计了这项研究，以确定导线导管是否降低了ERCP术后高淀粉血症和胰腺炎的发生率病人和方法。74例肝胆疾病患者在德黑兰塔莱加尼转诊医院连续接受了诊断或治疗性ERCP。其中有546例患者接受了线引导下插管并接受了该手术，其他患者则采用造影剂注射作为常规方法进行了括约肌切开胆道插管。结果：两组患者的性别和年龄均相当。导丝组和常规组的成功胆道插管相似（分别为89.2％和86.4％），其中分别有5.4％和14.1％的患者难以进行胆管插管（P = 0.003）。常规组中99.0％的患者的主胰管可视化程度高于另一组中的79.0％（P <0.001）。多元回归分析表明，金属丝导管插管对ERCP术后高淀粉血症具有保护作用（OR：0.336，95％CI：0.181–0.623，P <0.001）。然而，两组在其他与手术相关的并发症（例如胰腺炎，出血和穿孔）的发生率方面无显着差异。结论。与常规方法相比，导丝插管的使用可降低ERCP后的发生高淀粉血症，因此建议选择这种插管技术，尤其是在高危人群中。

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