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针刀缩切除术并不能独立增加ERCP后胰腺炎:20年后期队列研究,倾向性得分匹配

Antonios Vezakis¹, George Tribonias², Petros Zormpas³

¹Endoscopy Department, 2nd Academic Surgical Unit, National and Kapodistrian University of Athens, Aretaieion Hospital, 11528, Athens, Greece.

Surgical endoscopy

|October 28, 2025

概括

当考虑程序复杂性时,针刀缩切除术 (NKS) 不会独立地增加ERCP后胰腺炎 (PEP) 的风险. 然而,NKS与更高的穿孔率有关,这表明在特定情况下早期使用可能会改善结果.

科学领域:

胃肠病学胃肠病学
内镜逆行胆血管细胞造影 (ERCP) 是一种内镜逆行胆血管细胞造影.

背景情况:

在ERCP期间使用预切割技术和针刀切除术 (NKS) 进行困难的胆道通道.
从历史上看,NKS与更高的并发症有关,但这可能是由于程序的复杂性.
本研究评估了NKS与ERCP后胰腺炎 (PEP) 和不良事件的独立关联.

研究的目的:

评估NKS与PEP和其他不良事件的独立关联.
将NKS与标准的内镜缩切除术 (ES) 进行比较,用于困难的道化病例.
为了确定NKS是否会增加并发症的风险,当程序复杂性得到控制.

主要方法:

一个单一运营商对2786个ERCP进行了回顾性观察研究 (2001-2021年).
患者被分为NKS (失败标准管后) 和初级ES.
倾向性得分匹配和多变量逻辑回归调整为混因素.

主要成果:

在NKS组中,PEP最初较高,但在调整后不显著 (aOR1.68).
独立的PEP预测因素包括≥5次管试验,胰腺管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管管.
穿孔风险在NKS (aOR 5.35) 显著增加,导致整体并发症增加 (aOR 1.80).

结论:

当考虑程序复杂性时,NKS不会独立增加PEP风险.
NKS与更高的穿孔风险有关.
在选定的情况下,早期使用NKS可能会改善结果,强调运营商的专业知识.

关键词:

在 ERCP 中,ERCP 已成为 ERCP 的核心.这是一把针刀刀.这就是PEPEP的意义.进行乳头切除术 (papillotomy).预剪的预剪的

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