CAJ | 학술논문

目的评价ERCP插管困难患者择期行二次ERCP的安全性及其临床价值.方法 212例ERCP插管困难患者,常规插管失败后先行乳头预切开,然后再尝试插管,超过1h仍未能成功插管者择期行二次ERCP诊疗,统计首次ERCP和总体ERCP(首次ERCP+二次ERCP)插管成功率及并发症发生率,并行统计学分析.结果首次ERCP插管成功率为67.0％(142/212),总体ERCP插管成功率为90.6％(192/212),总体ERCP插管成功率明显高于首次ERCP(x2=35.263,P＜0.05).首次ERCP并发症发生率为8.96％(19/212),总体ERCP并发症发生率为10.38％(22/212),其中二次ERCP并发症发生率为4.29％ (3/70),总体ERCP以及二次ERCP并发症发生率与首次ERCP比较差异均无统计学意义(P＞0.05).结论 ERCP插管困难行乳头预切开后仍不能完成插管者,择期行二次ERCP安全有效.
목적 평개ERCP삽관곤난환자택기행이차ERCP적안전성급기림상개치.방법 212례ERCP삽관곤난환자,상규삽관실패후선행유두예절개,연후재상시삽관,초과1h잉미능성공삽관자택기행이차ERCP진료,통계수차ERCP화총체ERCP(수차ERCP+이차ERCP)삽관성공솔급병발증발생솔,병행통계학분석.결과 수차ERCP삽관성공솔위67.0％(142/212),총체ERCP삽관성공솔위90.6％(192/212),총체ERCP삽관성공솔명현고우수차ERCP(x2=35.263,P＜0.05).수차ERCP병발증발생솔위8.96％(19/212),총체ERCP병발증발생솔위10.38％(22/212),기중이차ERCP병발증발생솔위4.29％ (3/70),총체ERCP이급이차ERCP병발증발생솔여수차ERCP비교차이균무통계학의의(P＞0.05).결론 ERCP삽관곤난행유두예절개후잉불능완성삽관자,택기행이차ERCP안전유효.
Objective To determine the safety and clinical value of secondary ERCP to a failed intubation procedure.Methods A total of 212 patients with difficult intubation during ERCP procedures were enrolled.Patients with failed conventional intubation accepted precut sphincterotomy.The operation stopped after one hour of effort.A secondary selective ERCP was performed at a appropriate time.The operation success rate and complication rate of first ERCP and secondary ERCP were compared.Results The success rate of first ERCP was 67.0％ (142/212),and the total success rate was 90.6％ (192/212).The total success rate is significantly higher than that of first ERCP operation(x2 =35.263,P ＜0.05).The complication rate of first ERCP,secondary ERCP and total complication rate was 8.96％ (19/212),4.29％ (3/70),10.38％ (22/212),respectively.Complication rates of total ERCP and secondary ERCP were not significantly different from the first ERCP (P ＞ 0.05).Conclusion It is safe and effective for patients with failed ERCP intubations after precut to receive a secondary ERCP at a appropriate time.