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首页> 外文期刊>Surgical Endoscopy >Possible mortality reduction by endoscopic sphincterotomy during endoscopic retrograde cholangiopancreatography: a population-based case-control study.
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Possible mortality reduction by endoscopic sphincterotomy during endoscopic retrograde cholangiopancreatography: a population-based case-control study.

机译：内镜逆行胰胆管造影术期间内镜括约肌切开术可能降低死亡率：一项基于人群的病例对照研究。

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Endoscopic retrograde cholangiopancreatography (ERCP) is widely used for young patients, but ERCP and endoscopic sphincterotomy in particular are reported to be associated with increased complication and mortality rates. This study aimed to calculate mortality and to identify risk factors for death within 90 days after ERCP for nonmalignant disease.From the Swedish Hospital Discharge Registry, the authors identified all individuals in Stockholm County who had undergone in-patient ERCP during 1990-2003. Among these individuals, they excluded those recorded in the Swedish Cancer Registry as having a diagnosis of malignancy in the liver, pancreas, or bile ducts. Cases, defined as patients who had died within 90 days after the procedure, were identified by cross-linkage to the causes of death registry. Control subjects were randomly sampled from the same cohort. The medical records were studied to discern risk factors for death after ERCP.The mortality rate was 1.6%. Advanced age, severe comorbidity, high complexity of the procedure, and occurrence of a complication were associated with death within 90 days, whereas a previous cholecystectomy or the simultaneous performance of an endoscopic sphincterotomy reduced the risk.Old age and comorbidity are the main risk factors for death after ERCP, but a complex procedure or the occurrence of a complication also seems to increase short-term mortality. The performance of a sphincterotomy may reduce the risk of death, possibly by facilitating adequate drainage. A previous cholecystectomy also may decrease the risk of death after ERCP.
机译：内镜逆行胰胆管造影术（ERCP）被广泛用于年轻患者，但是据报道，特别是ERCP和内镜括约肌切开术与并发症和死亡率增加有关。这项研究旨在计算死亡率并确定非恶性疾病ERCP后90天内死亡的危险因素。作者从瑞典医院出院登记处确定了1990-2003年斯德哥尔摩郡所有住院ERCP的患者。在这些个体中，他们排除了在瑞典癌症登记处记录的诊断为肝，胰或胆管恶性肿瘤的个体。病例定义为在手术后90天内死亡的患者，通过与死亡原因登记表的交叉链接进行鉴定。从同一队列中随机抽取对照组受试者。对病历进行研究以识别ERCP后死亡的危险因素，死亡率为1.6％。高龄，严重合并症，手术的高度复杂性以及并发症的发生与90天之内的死亡有关，而先前的胆囊切除术或同时进行内镜括约肌切开术降低了风险。高龄和合并症是主要的危险因素ERCP术后死亡的原因，但是复杂的手术或并发症的发生似乎也增加了短期死亡率。进行括约肌切开术可能通过促进充分引流来降低死亡风险。先前的胆囊切除术也可以降低ERCP术后的死亡风险。

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