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首页> 外文期刊>Endoscopy International Open >Endoscopic sphincterotomy to prevent post-ERCP pancreatitis in patients with biliary neoplasms: a multicenter retrospective cohort study
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Endoscopic sphincterotomy to prevent post-ERCP pancreatitis in patients with biliary neoplasms: a multicenter retrospective cohort study

机译：内镜晶状体切开术，以防止胆道肿瘤患者ERCP后胰腺炎：多中心回顾队列研究

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Background and aims?Treatment of biliary neoplasms often involves multiple endoscopic retrograde cholangiopancreatography (ERCP)-related procedures. Endoscopic sphincterotomy (ES) may prevent post-ERCP pancreatitis (PEP). This retrospective, multicenter cohort study aimed to investigate the effectiveness of ES for prevention of PEP in patients with biliary neoplasm. Methods?Patients with biliary duct neoplasm who underwent ERCP between January 2006 and December 2016 were enrolled. The frequency of PEP was compared between the ES and non-ES groups using propensity score analysis. The effectiveness of ES in subgroups of patients who underwent biliary duct stent placement, intraductal ultrasound (IDUS), and transpapillary biliary duct biopsy was analyzed by logistic regression. Results?Of the 362 patients enrolled, 84 (23.2?%) developed PEP. Propensity score matching for PEP risk factors in 172 ERCP procedures showed that the frequency of PEP in the ES group was lower than that in the non-ES group (19.7?% vs. 33.7?%). Non-ES was also an independent risk factor for PEP in patients who underwent intraductal ultrasound and transpapillary biliary duct biopsy (RR?=?4.54 and 5.26), but was not an independent risk factor for PEP in patients with biliary duct stents. In addition, there was no evidence that the frequency of PEP was statistically different between patients with plastic stents and metal stents in the ES and non-ES groups (P?=?0.14 and 0.10). Conclusions?ES is an effective technique to prevent PEP in patients with biliary neoplasms. In particular, ES is a safe technique to prevent PEP when performing IDUS and transpapillary biliary duct biopsy.
机译：背景和目标？胆道肿瘤的治疗通常涉及多个内窥镜逆行胆管胰岛素（ERCP）相关的程序。内窥镜括约肌术可以防止ERCP后胰腺炎（PEP）。这种回顾性的多中心队列研究旨在探讨ES在胆道肿瘤患者预防PEP的有效性。方法？患有2006年1月至2016年12月在2016年1月至2016年12月之间接受ERCP的胆道导管肿瘤的患者。使用倾向评分分析比较ES和非ES组之间的PEP频率。通过Logistic回归分析了对胆道管道放置，内部外血管和转基状胆管性活检的患者亚组的有效性。结果？362名患者注册，84名（23.2？％）开发了PEP。在172次ERCP程序中对PEP风险因素匹配的倾向得分表明，ES组的PEP频率低于非ES组（19.7〜33.7？％）。非ES也是患有内部内膜和转膜胆管导管活组织检查（RR？= 4.54和5.26）的患者的独立危险因素，但不是胆管支架患者的PEP的独立危险因素。此外，没有证据表明，ES和非ES组中的塑料支架和金属支架的患者之间的PEP频率是统计学不同的（p？= 0.14和0.10）。结论？ES是预防胆道肿瘤患者的有效技术。特别是，当执行IDU和转膜胆管活检时，ES是防止PEP的安全技术。

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