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现实世界的证据比较早期和晚期的胰腺支架放置以预防ERCP后胰腺炎
Shaofei Wang1,2, Bingqing Bai2, Qiming Huang2
1Department of Gastroenterology, Suzhou First People's Hospital, Suzhou, Anhui Province, China.
Endoscopy international open
|October 16, 2024
概括
与晚期安置相比,早期安置胰腺支架显著降低了ERCP后胰腺炎 (PEP) 和超胺血症的风险. 这种时间对于预防内镜手术后的并发症至关重要.
科学领域:
- 胃肠病学 胃肠病学
- 内镜手术 进行内镜手术
- 胰腺干预 胰腺干预
背景情况:
- 胰腺支架在预防ERCP后胰腺炎 (PEP) 中是有效的.
- 胰腺支架安置的最佳时间仍未得到充分研究.
- 这项研究涉及早期与晚期支架安置的疗效.
研究的目的:
- 为了比较早期胰腺支架安置 (EPSP) 与晚期胰腺支架安置 (LPSP) 在预防PEP方面的有效性.
- 为了评估支架定时对超胺血症发病率的影响.
- 确定胰腺支架安置的最佳时机,在经过艰难胆道管治疗的天真乳头患者中.
主要方法:
- 对590名患有难以胆管通道的患者进行了回顾性队列研究.
- 患者被分为EPSP (立即在ERC/EST之前/之后放置的支架) 和LPSP (在程序完成后放置的支架) 组.
- 分析包括多变量和倾向分数匹配 (PSM) 分析.
主要成果:
- 与LPSP相比,EPSP与明显较低的PEP发生率相关 (2.9%与7.3%,P=0.012).
- 在EPSP组中,超胺血症的发病率也较低 (19.7%与27.8%,P=0.026).
- 调查结果在所有敏感性分析中一致,包括PSM分析.
结论:
- 早期的胰腺支架安置在减少PEP发病率方面比晚安置更有效.
- 此外,EPSP还可以降低术后超胺血症的发生率.
- 在ERC/EST之前或之后立即进行胰腺支架是预防PEP的最佳选择.
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