Endoscopic retrograde cholangiopancreatography in acute biliary pancreatitis combined with pregnancy / 中华消化内镜杂志

ABSTRACT

Objective To observe the effect and safety of endoscopic retrograde cholangiopancre-atography(ERCP)in pregnant patients with acute biliary pancreatitis(ABP). Methods Twenty-four ABP patients,14 mild and 10 severe cases combined with pregnancy,were hospitalized from Januaray 2002 to Januaray 2007. Besides conventional managements,emergency endoscopic nasobiliary drainage(ENBD) without monitor of X-ray was performed in all patients to decrease the pressure in bile duct. Once the condi- tion of the patients Was stabilized and the common bile duct stone was confirmed,secondary endoscopic retro- grade biliary drainage(ERBD)with stent was performed in patients at early and midtrimester pregnancy,while secondary ERCP was employed in late pregnant patients after pregnancy termination. Results All pa-tients safely went through emergency ENBD without complication,and 4 patients with ampulla incarceration accepted sphinectomy with needle knife and stones were removed successfully. Common bile duct stone was confirmed in 15 patients and 5 of them underwent ERBD,the other 10 accepted ERCP. No patient died or needed surgical intervention,and they were all discharged with complete remission. Fetus of two patient with severe ABP did not survive. Conclusion Emergency ENBD and secondary ERCP or ERBD are safe and ef-fective in management of pregnancy patient with ABP.