在预防后内镜乳头气球扩张胰腺炎方面,内镜鼻排水优于胆管支架
Junlong Lin1, Baifeng Qian1, Zhichao Li1
1Center of Hepato-Pancreato-Biliary Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China.
Therapeutic advances in gastroenterology
|September 2, 2025
概括
内镜鼻疏通 (ENBD) 是内镜乳头气球扩张 (EPBD) 后常见胆道结石 (CBDS) 的安全和有效选择,可能降低胰腺炎风险,特别是在多种结石患者中.
科学领域:
- 胃肠病学
- 内镜检查方法
- 胆道疾病
背景情况:
- 透视乳头气球扩张 (EPBD) 是常见胆道结石 (CBDS) 的关节保护替代方法.
- 对比EPBD后的排水方法对于优化患者的治疗结果至关重要.
研究的目的:
- 评估内鼻胆道排水 (ENBD) 与内逆行胆道排水 (ERBD) 在CBDS后的安全性和有效性.
- 在ENBD和ERBD组中比较ERCP后胰腺炎 (PEP) 的发生率.
主要方法:
- 对283名接受EPBD,随后接受ENBD或ERBD的CBDS患者进行回顾性分析.
- 使用倾向分数匹配 (PSM) 来平衡患者群体,结果为220名匹配患者.
- 分析了PEP的发生率和风险因素.
主要成果:
- 在PSM后,研究小组之间没有显著的基线差异.
- 在ENBD群体中,血清胆红素水平降低较大.
- 在PSM (p=0. 045) 后,PEP发病率在ENBD组 (2. 7%) 与ERBD组 (9. 1%) 相比显著较低.
- 多个石头可能会增加PEP的风险.
结论:
- 对于接受EPBD的CBDS患者来说,ENBD是潜在的最佳选择.
- 在考虑PEP风险时,多个石头的存在是一个相关因素.
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