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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Issue 5
May  2017
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Association between hematobilia and primary disease after therapeutic endoscopic retrograde cholangiopancreatography

DOI: 10.3969/j.issn.1001-5256.2017.05.021
  • Published Date: 2017-05-20
  • Objective To investigate the difference in the risk of hematobilia after therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in patients with different primary diseases.Methods A retrospective analysis was performed for the clinical data of 685 patients with pancreaticobiliary diseases who underwent therapeutic ERCP in General Hospital of Chengdu Military Region from June 2013 to June 2016.According to the presence or absence of hematobilia after ERCP, they were divided into bleeding group (29 patients) and non-bleeding group (656 patients) .The association between primary disease and the risk of bleeding was evaluated.The chi-square test was used for comparison of categorical data between groups, and the independent samples t-test was used for comparison of continuous data between groups.Results The overall incidence rate of hematobilia after ERCP was 4.2% (29/685) , and among these patients, 21 had early bleeding and 8 had delayed bleeding.The bleeding group had a significantly higher incidence rate of hypertension than the non-bleeding group (65.5% vs 25.6%, χ2=22.286, P<0.001) 2="5.356," .compared="" with="" the="" non-bleeding="" bleeding="" group="" had="" significantly="" higher="" proportions="" of="" patients="" impacted="" ampullar="" stones="" vs="" p="" cholangiocarcinoma="" pancreatic="" cancer="" and="" carcinoma="" .there="" were="" no="" significant="" differences="" between="" two="" groups="" in="" common="" bile="" duct="" acute="" pyogenic="" biliary="" inflammatory="" stenosis="" after="" surgery="" all="">0.05) .Conclusion Patients with impacted ampullar stones or malignant pancreaticobiliary diseases have a high risk of hematobilia after ERCP and should be given adequate preoperative preparation, effective intraoperative hemostasis, and strengthened postoperative prevention.

     

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  • [1]TALUKDAR R.Complications of ERCP[J].Best Pract Res Clin Gastroenterol, 2016, 30 (5) :793-805.
    [2]WANG JH, GAO G, SHI JJ.Causes and countermeasures of delayed hemobilia after endoscopic retrograde cholangiopancreatography[J].J Clin Hepatol, 2013, 29 (9) :692-694. (in Chinese) 王继恒, 高革, 史久健.经内镜逆行胰胆管造影术后迟发性胆道出血的原因和应对措施[J].临床肝胆病杂志, 2013, 29 (9) :692-694.
    [3]SUN Y, WANG Q.Treatment of delayed hematobilia after endoscopic sphincterotomy[J].Chin J Surg Integr Tradit West Med, 2016, 22 (3) :279-281. (in Chinese) 孙燕, 王庆.内镜下乳头肌切开术后迟发性胆道出血的治疗观察[J].中国中西医结合外科杂志, 2016, 22 (3) :279-281.
    [4]CHAVALITDHAMRONG D, DONEPUDI S, PU L, et al.Uncommon and rarely reported adverse events of endoscopic retrograde cholangiopancreatography[J].Dig Endosc, 2014, 26 (1) :15-22.
    [5]LI JM, LI Y, WEI F.Exploration of risk factors and preventive measures for patients with bile-duct haemorrhage after ERCP[J].Med J West China, 2012, 24 (3) :600-602. (in Chinese) 李俊梅, 李芸, 魏芳.ERCP术后并发胆道出血的危险因素及防护[J].西部医学, 2012, 24 (3) :600-602.
    [6]DARRIEN JH, CONNOR K, JANECZKO A, et al.The surgical management of concomitant gallbladder and common bile duct stones[J].HPB Surg, 2015, 2015:165068.
    [7]BANSAL VK, MISRA MC, RAJAN K, et al.Single-stage laparoscopic common bile duct exploration and cholecystectomy versus two-stage endoscopic stone extraction followed by laparoscopic cholecystectomy for patients with concomitant gallbladder stones and common bile duct stones:a randomized controlled trial[J].Surg Endosc, 2014, 28 (3) :875-885.
    [8]MARCH B, BURNETT D, GANI J.Single-stage laparoscopic cholecystectomy and intraoperative endoscopic retrograde cholangiopancreatography:is this strategy feasible in Australia?[J].ANZ JSurg, 2016, 86 (11) :874-877.
    [9]HENDRIKS MP, WANTEN GJ, DRENTH JP.Management of hemobilia and pancreatitis after liver biopsy:a key role for endoscopic retrograde cholangiopancreaticography[J].Liver Transpl, 2009, 15 (11) :1653-1654.
    [10]LIU TX, FANG DH, GUAN YB, et al.Diagnosis and treatment of biliary tract bleeding[J].J Hepatobiliary Surg, 2014, 22 (4) :286-289. (in Chinese) 刘天锡, 方登华, 关斌颖, 等.胆道出血的原因诊断与治疗[J].肝胆外科杂志, 2014, 22 (4) :286-289.
    [11]ZHANG XY.Analysis and measures on risk factors of ERCP postoperative hemobilia[J].Clin Med Eng, 2014, 21 (6) :751-752. (in Chinese) 张新亚.ERCP术后并发胆道出血的危险因素分析及措施[J].临床医学工程, 2014, 21 (6) :751-752.
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