在有困难的选择性胆道管治疗的情况下,停止ERCP的最佳时间
1Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea (the Republic of).
Endoscopy international open
|April 15, 2025
概括
在ERCP期间停止困难的选择性胆道管 (SBC) 约8分钟可能会降低ERCP后胰腺炎 (PEP) 的风险. 然而,将尝试延长到12分钟可以平衡成功率和并发症.
科学领域:
- 胃肠病学 胃肠病学
- 内镜检查是指内镜检查.
- 胆汁干预 胆汁干预
背景情况:
- 在ERCP中长时间管增加了ERCP后胰腺炎 (PEP) 的风险.
- 优化管时间对于患者的安全至关重要.
研究的目的:
- 确定选择性胆道通道 (SBC) 难以停止ERCP的最佳时间.
- 评估管时间,成功率和PEP风险之间的关系.
主要方法:
- 对272名经过ERCP的原始乳头患者进行了回顾性分析.
- 主要结局:基于管成功率和并发症率,停止ERCP的最佳时间.
- 分析了与时间对比的PEP率和SBC成功率.
主要成果:
- 在91.5%的病例中实现了选择性胆管管道 (SBC).
- 在分析患者中,ERCP后胰腺炎 (PEP) 发生在5.5%的患者中.
- PEP风险在7.9分钟达到10%,在12.1分钟达到14.5%,在12.1分钟达到90%的SBC成功率.
结论:
- 在8分钟左右停止困难的SBC尝试可能会最大限度地降低PEP风险.
- 将尝试延长到12分钟可以证明SBC成功率更高.
- 超过12分钟的成功率显著下降,这表明这是一个实际的极限.
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