慢性肝病作为ERCP后并发症的危险因素:全国性的回顾性分析
Madhav Changela1, Janak Bahirwani2, Ernestine Faye Tan1
1Department of Internal Medicine, One Brooklyn Health System/Interfaith Medical Center.
Journal of clinical gastroenterology
|January 8, 2025
概括
患有慢性肝病 (CLD) 的患者在内镜逆向胆血管瘤造影 (ERCP) 后面临更高的并发症风险,包括胰腺炎和出血. 建议对这种人群明智地使用ERCP,因为增加了住院死亡率和更长的住院时间.
科学领域:
- 胃肠病学 胃肠病学
- 肝病学 肝病学是一种肝病学.
- 内镜手术 进行内镜手术
背景情况:
- 透视逆行胆血管瘤造影 (ERCP) 对于胰腺和胆道疾病至关重要,但具有重大风险.
- 关于慢性肝病 (CLD) 作为ERCP并发症的危险因素的研究是有限的.
- 这项研究评估了CLL患者与没有CLL患者的ERCP结果.
研究的目的:
- 为了评估ERCP在患有CLD的患者的结果.
- 为了比较患有和没有结核病的患者之间的并发症率 (胰腺炎,出血,穿孔).
- 评估二次结果,如住院死亡率和住院时间长度.
主要方法:
- 使用了国家住院样本 (NIS) 数据库 (2016-2019).
- 经过ERCP的成年患者分层分为CLD和非CLD组.
- 使用多变量回归分析ERCP后的胰腺炎,出血,穿孔,死亡率和停留时间.
主要成果:
- 确定了883,825名ERCP患者;2.4%的人患有CLD.
- 患有CLD的患者显示ERCP后胰腺炎 (8.8%vs. 6.7%) 和出血 (8.8%vs. 6.69%) 的发生率显著更高.
- 慢性结核病患者在医院死亡率较高 (3.03%对1.58%),住院时间较长 (7对3天).
结论:
- 患有CLD的患者有ERCP相关并发症和不良结果的风险增加.
- 在患有CLD的患者中,应谨慎使用ERCP.
- 需要进一步的研究来确定可逆风险因素,以改善这一患者群体的治疗结果.
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