良性胆胰疾病内镜下乳头括约肌切开术后远期并发症的危险因素分析

丁世华; 吴东海; 郭海建; 刘俊

doi:10.3969/j.issn.1001-5256.2016.05.022

良性胆胰疾病内镜下乳头括约肌切开术后远期并发症的危险因素分析

DOI: 10.3969/j.issn.1001-5256.2016.05.022

深圳大学第一附属医院消化内科

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中图分类号: R657.4
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出版历程
- 收稿日期: 2015-10-20
- 出版日期: 2016-05-20

Risk factors for long-term complications after endoscopic sphincterotomy for benign biliary and pancreatic diseases

Department of Gastroenterology,The First Affiliated Hospital of Shenzhen University

摘要

摘要: 目的分析良性胆胰疾病内镜下乳头括约肌切开术（EST）术后远期并发症的危险因素。方法回顾分析2008年7月-2013年6月在深圳大学第一附属医院消化内科行EST的患者随访资料,探讨EST术后远期并发症发生的危险因素。两组间比较采用χ2检验,采用Kaplan-Meier法分析并发症累积发生率,单因素以及多因素Logistic回归分析远期并发症的危险因素。结果所有患者随访457个月,平均随访（30.9±12.1）个月。EST术后远期并发症累积发生率为9.9%（18/182）,包括复发性胆总管结石9例,复发性胆管炎6例,急性胆囊炎2例,胆道狭窄1例;单因素分析显示,胆总管直径、憩室旁乳头、胆道积气组间差异均有统计学意义（P值均<0.05）,进一步多因素Logistic回归分析显示,胆总管直径≥15 mm和胆道积气是EST术后远期并发症发生的危险因素[比值比（OR）=4.82,95%可信区间（95%CI）:1.0821.55,P=0.040;OR=6.19,95%CI:1.2331.23,P=0.027]。结论良性胆胰疾病E...
- 括约肌切开术,内窥镜 /
- 手术后并发症 /
- 危险因素
Abstract: Objective To investigate the risk factors for long- term complications after endoscopic sphincterotomy( EST) for benign biliary and pancreatic diseases. Methods The follow- up data of the patients who underwent EST in Department of Gastroenterology,The First Affiliated Hospital of Shenzhen University,from July 2008 to June 2013 were analyzed retrospectively,and the risk factors for long- term complications after EST were investigated. The chi- square test was applied for comparision of categorical data betwee groups. The Kaplan-Meier method was applied to analyze the cumulative incidence of complications,and the univariate and multivariate logistic regression analyses were applied to investigate the risk factors for long- term complications. Results The patients were followed up for 4- 57 months,and the mean follow- up time was 30. 9 ± 12. 1 months. The cumulative incidence of long- term complications after EST was 9. 9%( 18 /182),and these complications included recurrent common bile duct stones( n = 9),recurrent cholangitis( n = 6),acute cholecystitis( n = 2),and biliary stricture( n = 1). There were significant differences between the two groups in diameter of common biledute,pneumobilia,and juxtapapillary diverticulum( all P < 0. 05). The multivariate logistic regression analysis showed that diameter of common bile duct ≥15 mm( OR = 4. 82,95% CI: 1. 08- 21. 55,P = 0. 040) and pneumobilia( OR = 6. 19,95% CI: 1. 23- 31. 23,P = 0. 027) were the risk factors for long- term complications after EST. Conclusion The incidence of long- term complications after EST for benign biliary and pancreatic diseases is low,and diameter of common bile duct ≥15 mm and pneumobilia are the risk factors for long- term complications after EST.
- sphincterotomy,endoscopic /
- postoperative complications /
- risk factors

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参考文献(15)

[1]HU L,SUN X,HAO J,et al.Long-term follow-up of therapeutic ERCP in 78 patients aged 90 years or older[J].Sci Rep,2014,4(4):4918.

[2]KATSINELOS P,LAZARAKI G,CHATZIMAVROUDIS G,et al.Risk factors for therapeutic ERCP-related complications:an analysis of 2,715 cases performed by a single endoscopist[J].Ann Gastroenterol,2014,27(1):65-72.

[3]ELMI F,SILVER MAN WB.Long-term biliary endoscopic sphincterotomy restenosis:incidence,endoscopic management,and complications of retreatment[J].Dig Dis Sci,2010,55(7):2102-2107.

[4]BELTZ S,SARKAR A,LOREN DE,et al.Risk stratification for the development of post-ERCP pancreatitis by sphincter of Oddi dysfunction classification[J].South Med J,2013,106(5):298-302.

[5]SUGAWA C,BROWN KL,MATSUBARA T,et al.The role of endoscopic biliary sphincterotomy for the treatment of type 1 biliary dysfunction(papillary stenosis)with or without biliary stones[J].Am J Surg,2014,207(1):65-69.

[6]SUGIYAMA M,SUZUKI Y,ABE N,et al.Endoscopic retreatment of recurrent choledocholithiasis after sphincterotomy[J].Gut,2004,53(12):1856-1859.

[7]WOJTUN S,GIL J,GIETKA W,et al.Endoscopic sphincterotomy for choledocholithiasis:a prospective single-center study on the short-term and long-term treatment results in 483 patients[J].Endoscopy,1997,29(4):258-265.

[8]MANDRYKA Y,KLIMCZAK J,DUSZEWSKI M,et al.Bile duct infections as a late complication after endoscopic sphincterotomy[J].Pol Merkur Lekarski,2006,21(126):525-527.

[9]FUJIMOTO T,TSUYUGUCHI T,SAKAI Y,et al.Long-term outcome of endoscopic papillotomy for choledocholithiasis with cholecystolithiasis[J].Dig Endosc,2010,22(2):95-100.

[10]KAGEOKA M,WATANABE F,MARUYAMA Y,et al.Long-term prognosis of patients after endoscopic sphincterotomy for choledocholithiasis[J].Dig Endosc,2009,21(3):170-175.

[11]LAI JH,WANG HY,CHANG WH,et al.Recurrent cholangitis after endoscopic lithotripsy of common bile duct stones with gallstones in situ:predictive factors with and without subsequent cholecystectomy[J].J Laparoendosc Adv Surg Tech A,2012,22(4):324-329.

[12]ANDO T,TSUYUGUCHI T,OKUGAWA T,et al.Risk factors for recurrent bile duct stones after endoscopic papillotomy[J].Gut,2003,52(1):116-121.

[13]TSAI TJ,LAI KH,LIN CK,et al.The relationship between gallbladder status and recurrent biliary complications in patients with choledocholithiasis following endoscopic treatment[J].J Chin Med Assoc,2012,75(11):560-566.

[14]PEREIRA-LIMA JC,JAKOBS R,WINTER UH,et al.Long-term results(7 to 10 years)of endoscopic papillotomy for choledocholithiasis.Multivariate analysis of prognostic factors for the recurrence of biliary symptoms[J].Gastrointest Endosc,1998,48(5):457-464.

[15]SAITO M,TSUYUGUCHI T,YAMAGUCHI T,et al.Long-term outcome of endoscopic papillotomy for choledocholithiasis with cholecystolithiasis[J].Gastrointest Endosc,2000,51(5):540-545.

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