ABSTRACT
Objective To study the effect of indomethacin preventing post-ERCP pancreatitis ( PEP ) on the patients younger than 50 years undergoing small endoscopic sphincterotomy (sEST) combined with endoscopic papillary balloon dilation(EPBD) in the treatment of choledocholithiasis. Methods 202 patients younger than 50 years with choledocholithiasis were divided into two groups, 101 patients in treatment group before surgery were rectal administrated with indometacin, 101 patients in control group were administered with placebo, all patients underwent sEST combined with EPBD in the treatment of choledocholithiasis.After operation,the abdominal pain NRS score, amylase, incidence of pancreatitis and hospitalization time were recorded, and the rates of heartburn, rash, gastrointestinal bleeding were recorded.Results In the treatment group, pain NRS score 24 hours after operation was(0.327 ±0.763), amylase 24 hours after operation was (116.87 ±113.97) U/L, there were 3 cases of postoperative pancreatitis (2.97%) in the treatment group,and the postoperative hospitalization time was (6.42 ±2.11) days.In the control group, pain NRS score 24 hours after operation was ( 0.634 ±1.027 ) , amylase 24 hours after operation was ( 185.38 ±160.60 ) U/L, there were 11 cases of postoperative pancreatitis (10.89%) in the control group, and the postoperative hospitalization time were (7.29 ±2.71) days.The differences of NRS pain score, amylase, incidence of pancreatitis, postoperative hospitalization time between these two groups were statistically significant ( P<0.05 ) .The differences of the rates of postoperative heartburn, rash, gastrointestinal bleeding between these two groups were not statistically significant.Conclusion Indomethacin rectal administration can prevent post-ERCP pancreatitis ( PEP ) on the patients who undergoing sEST combined with EPBD in the treatment of choledocholithiasis,and this administration is quite security.
ABSTRACT
Objective To observe the clinical effect of small endoscopic sphincterectomy (SES) combined with endoscopic papillary balloon dilation (EPBD) in the treatment of large common bile duct stones.Methods The patients were randomly divided into 3 groups:normal endoscopic sphincterotomy(EST),EPBD,SES combined with EPBD.The incidence of pancreatitis at 1 week after operation and the recurrence rate of inner duct stone within 15 months after operation were statistically analyzed.Results At 1 week after treatment,the incidence of pancreatitis was lower in group EST and group SES combind with EPBD than in group EPBD [3.3％ (1/30),3.3％ (1/30) vs.20.0％ (6/30),both P＜0.05].After 15 months of treatment,the recurrence rate of inner duct stone were lower in group B and group C than in group A 3.3％ (1/30),3.3％ (1/30) vs.23.3％(7/30),both P＜0.05).Conclusions In the treatment of large common bile duct stones,SES combined with EPBD can reduce the incidence of postoperative acute pancreatitis and the longterm recurrence rate of common bile duct stones.
ABSTRACT
Objective To evaluate the efficacy of chaihu shugan san plus polyene phosphatidylcholine for non-alcoholic fatty liver disease(NAFLD).Methods Ninety patients with NAFLD were randomly divided into 3groups(each n=30):polyene phosphatidylcholine group(Group A),chaihu shugan san group(Group B),and chaihu shugan san plus polyene phosphatidylcholine group(Group C).The clinical symptom scores,biochemistry index (ALT,AST,GGT,TBIL,TC,TG,HLD-C,LDL-C),and B ultrasound examination were measured.Results There were significant differences in clinical symptom scores,ALT,AST,GGT,TBIL,TC,TG,and LDL-C between before and after treatment in the three groups(P＜0.05).After treatment,the clinical symptom scores,ALT,AST,TBIL,and LDL-C in Group C were significantly lower than those in Group A and Group B(P＜0.05).There were similar effects on TC and TG between Group B and Groop C,which were better than those in Group A(P＜0.05).Conclusion The efficacy of combined treatment of chaihu shugan san and polyene phosphatidylcholine was better than that of merely chaihu shugan san or tiopronin.