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首页> 外文期刊>Langenbeck's archives of surgery >The effects of contrast agent and intraductal pressure changes on the development of pancreatitis in an ERCP model in rats.
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The effects of contrast agent and intraductal pressure changes on the development of pancreatitis in an ERCP model in rats.

机译：ERCP模型大鼠中，造影剂和导管内压力变化对胰腺炎发展的影响。

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OBJECTIVE: Although there are various experimental pancreatic models in animals, only a few studies have evaluated how intraductal pressure and contrast agent affect the development of pancreatitis after endoscopic retrograde cholangiopancreatograpy (ERCP). MATERIALS AND METHODS: The rats were randomly divided into seven groups (n = 8/group). The rats in all groups underwent laparotomy and their biliopancreatic ducts were cannulated transduodenally using a 24G catheter. In the control group, group 1, the biliopancreatic ducts of the rats were not infused with any fluid. The biliopancreatic ducts of the rats in groups 2, 3, and 4 were infused with 0.5 ml isotonic NaCl solution at 10, 2, and 50 mmHg, respectively. Groups 5, 6, and 7 were given 0.5 ml of 50% diluted contrast agent at 10, 25, and 50 mmHg, respectively. The serum amylase, aspartate aminotransferase (AST), lactic dehydrogenase (LDH), and C-reactive protein (CRP) were measured 24 h after the procedure. Pancreatic tissue was also evaluated histopathologically. RESULTS: Pancreatitis due to the contrast agent was noted when comparing the low pressure isotonic NaCl group and the low pressure contrast group (p < 0.05). Based on serum amylase and CRP values, there was a positive correlation between the severity and frequency of acute pancreatitis and pressure (p < 0.01). AST and LDH levels increased in all of the groups that underwent the procedure; however, no correlation was detected with increasing pressure or with the use of contrast agent (p > 0.05). Both pancreatic edema and the inflammatory cell infiltration score were elevated in isotonic NaCl and contrast group (p < 0.05); however, necrosis was not significantly changed (p > 0.05). CONCLUSION: The results of this study suggest that the main mechanism for preventing pancreatitis after ERCP is to minimize trauma to the pancreatic canal, to cannulate the pancreas only when it is necessary, and to give contrast agent under low pressure when it is needed.
机译：目的：尽管动物实验胰腺模型多种多样，但只有少数研究评估了内镜逆行胰胆管胰腺炎（ERCP）后导管内压力和造影剂如何影响胰腺炎的发展。材料与方法：将大鼠随机分为七组（n = 8 /组）。所有组的大鼠均行剖腹手术，并使用24G导管经十二指肠插管其胆胰管。在对照组，第1组，大鼠的胰胆管未注入任何液体。在第2、3和4组的大鼠的胰胆管分别注入0.5 ml等渗NaCl溶液，分别为10、2和50 mmHg。第5、6和7组分别以0.5、10和25和50 mmHg的浓度服用0.5 ml的50％稀释造影剂。手术后24小时测量血清淀粉酶，天冬氨酸转氨酶（AST），乳酸脱氢酶（LDH）和C反应蛋白（CRP）。胰腺组织也进行了组织病理学评估。结果：在比较低压等渗NaCl组和低压造影剂组时，注意到由造影剂引起的胰腺炎（p <0.05）。根据血清淀粉酶和CRP值，急性胰腺炎的严重程度和频率与压力之间呈正相关（p <0.01）。接受该手术的所有组的AST和LDH水平均升高;但是，没有发现压力增加或使用造影剂的相关性（p> 0.05）。等渗NaCl和对比组的胰腺水肿和炎性细胞浸润评分均升高（p <0.05）;但是，坏死没有明显改变（p> 0.05）。结论：本研究结果表明，ERCP预防胰腺炎的主要机制是最大程度地减少胰管的创伤，仅在必要时才插管胰腺，并在需要时在低压下给予造影剂。

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