Risk factors and countermeasures for ERCP related duodenal papilla hemorrhage
10.3969/j.issn.1007-1989.2017.09.002
- VernacularTitle:治疗性内镜逆行胰胆管造影术后十二指肠乳头出血的客观危险因素分析
- Author:
Mei YONG
1
;
Jia JI-HU
;
Zeng PENG-FEI
;
Wang JUN
;
Wang GUO-XING
;
Du CHAO
;
Liu KAI
;
Li WEN-PING
;
Feng CHUN-LIN
;
Chen LENG
;
Wei KAI
Author Information
1. 遵义医学院第三附属医院(遵义市第一人民医院)肝胆外科
- Keywords:
biliary and pancreatic diseases;
endoscopic retrograde cholangiopancreatography;
complications;
duodenal papilla hemorrhage;
endoscopic hemostasis
- From:
China Journal of Endoscopy
2017;23(9):6-10
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors and countermeasures for endoscopic retrograde cholangiopancreatography (ERCP) related duodenal papilla hemorrhage. Methods Retrospective analysis was performed on the clinical data of 890 patients who underwent ERCP. According to whether the patients with ERCP related duodenal papilla hemorrhage, they were divided into the hemorrhage group and the non hemorrhage group. And the risk factors of duodenal papilla hemorrhage and their countermeasures were investigated. Results 51 patients had ERCP related duodenal papilla hemorrhage, and the overall incidence rate was 5.7%. Compared with the non hemorrhage group, the patients proportion of common bile duct stones was lower, but the cholangiocarcinoma and pancreatic head cancer were higher in the hemorrhage group (P < 0.05). The incidence of hypertension and duodenal diverticulum in the hemorrhage group were significantly higher than that in the non hemorrhage group (P < 0.05). Subgroup analysis showed that patients with stone diameter >2 cm, stone incarceration and the duodenal papilla into diverticulum in the hemorrhage group were significantly higher than that in the non hemorrhage group (P < 0.05). Conclusion Common bile duct stone diameter >2 cm, stone incarceration, malignant biliary and pancreatic cancer, hypertension and duodenal papilla into diverticulum were objective risk factors of ERCP related duodenal papilla hemorrhage, focus on prevention of bleeding. Endoscopic hemostasis was safe and effective.
