ABSTRACT
Background:Pancreatitis is the main complication of ERCP,and a variety of risk factors will increase its risk. Studies showed that temporary pancreatic duct stent can reduce the incidence of post-ERCP pancreatitis (PEP). Aims:To study the efficacy and safety of prophylactic pancreatic duct stenting on preventing PEP in patients with risk factors. Methods:Patients undergone ERCP and accompanied with one or more PEP-associated risk factors from November 2013 to November 2016 at Huaibei People's Hospital were enrolled,and were divided randomly into pancreatic duct stenting group (observation group)and non-stenting group (control group). Serum levels of amylase at 4,24 and 48 hours after the procedure and incidence of PEP were compared between the two groups. Results:A total of 297 patients were enrolled, and 147 patients were in observation group,and 150 patients in control group. No significant differences in gender,age and ERCP disease spectrum were found between the two groups (P > 0. 05). Incidence of PEP was significantly decreased in observation group than in control group (6. 1％ vs. 16. 0％,P 0. 05). Conclusions:Prophylactic pancreatic duct stenting may decrease the incidence of PEP in patients accompanied with PEP-associated risk factors, especially could decrease the severity of PEP. However, the incidence of hyperamylasemia is not decreased.
ABSTRACT
Objective To evaluate the role of diagnostic and therapeutic endoscopic retrograde cholangiopancreatography(ERCP)in bile duct injury. Methods Thirty-one patients with bile duct injury from March 1999 to March 2004 were managed by ERCP. Patients with indications of endoscopic therapy were treated by endoscopic sphincterectomy(EST)and plastic stent drainage. Results Twenty-two of 31 patients with bile duct injury received endoscopic therapy . The patients included 3 cases of common bile duct transection or ligation, 13 cases of bile duct stricture, and 15 cases of bile leakage. Seven of 13 patiens with bile duct stricture received plastic stent therapy, followed for 8-20 months, 4 cases with satisfaction and 3 cases with poor outcome. Fifteen cases of bile leakage accepted EST and endoscopic nasalbiliary drainage(ENBD) , in the first time,13 cases resulted in healing of the leakage,2 cases were of no effect. Seven cases of bile duct stricture were treated with plastic stent, maintaining for 4-12 months. No procedure related complications. Conclclusions ERCP is helpful not only for diagnosing and localizing localizing bile duct injury, but also for treating it in most of patients with relatively good and safe results.