Observation on the preventive effect of indwelling pancreatic duct guide wire through nasobiliary drainage tube for post-ERCP pancreatitis in cholelithiasis patients with small-caliber pancreatic duct
10.3760/cma.j.cn113884-20230802-00019
- VernacularTitle:经鼻胆管留置胰管导丝预防细径胰管胆囊结石和胆总管结石患者ERCP术后胰腺炎的疗效观察
- Author:
Anhua HUANG
1
;
Cheng ZHANG
;
Yulong YANG
;
Hai HU
;
Jingli CAI
;
Chuanqi HE
Author Information
1. 同济大学附属东方医院胆石病中心，上海 200120
- Keywords:
Pancreatitis;
Endoscopic retrograde cholangiopancreatography;
Hyperamylasemia;
Pancreatic stent
- From:
Chinese Journal of Hepatobiliary Surgery
2023;29(12):892-896
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the preventive effect of indwelling pancreatic duct guide wire through nasobiliary drainage catheter for post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) in cholelithiasis patients with small-caliber pancreatic duct.Methods:The clinical data of 127 patients with gall bladder and common bile duct stones undergoing ERCP and elective laparoscopic cholecystectomy in the Cholelithiasis Center of Shanghai East Hospital Affiliated to Tongji University from January 2019 to June 2023 were analyzed retrospectively, including 55 males and 72 females, aged (56.95±10.86) years old. According to the preventive methods of PEP, patients were divided into the guide wire group (indwelling pancreatic duct guide wire through nasobiliary drainage catheter), stenting group (nasobiliary catheter with 5Fr 5 cm single pigtail pancreatic duct stent) and conventional group (nasobiliary catheter). The incidence of post-ERCP hyperamylasemia (PEH) and PEP were compared.Results:The incidence of PEH in the guide wire group was lower than that in the conventional group [17.8% (8/45) vs. 43.5% (10/23), P=0.023], and also lower than that in the stenting group [17.8% (8/45) vs. 32.2% (19/59)], despite no statistical significance ( P=0.337). The incidences of PEH were comparable in the stenting group and conventional group [32.2% (19/59) vs. 43.5% (10/23), P=0.096)]. The incidence of PEP in the guide wire group was lower than that in both the stenting group [6.7% (3/45) vs. 23.7% (14/59), P=0.030]. and conventional group [6.7% (3/45) vs. 30.4% (7/23), P=0.025]. The incidences of PEP were comparable in the stenting and conventional group [23.7% (14/59) vs. 30.4% (7/23), P=0.532]. Conclusion:Compared to the preventive pancreatic duct stenting, indwelling pancreatic duct guide wire through nasobiliary drainage catheter can effectively prevent the PEH and PEP in high-risk patients with a small-caliber pancreatic duct.
