Treatment outcomes of endoscopic pancreatic sphincterotomy combined with pancreatic duct stent for acute recurrent pancreatitis caused by biliary microlithiasis
10.3760/cma.j.issn.1007-5232.2017.08.004
- VernacularTitle:胰管括约肌切开联合支架置入治疗胆道微结石性急性复发性胰腺炎的效果研究
- Author:
Wenzheng LIU
1
;
Hong CHANG
;
Yaopeng ZHANG
;
Wei YAO
;
Ke LI
;
Yonghui HUANG
Author Information
1. 北京大学第三医院消化科
- Keywords:
Pancreatitis;
Biliary microlithiasis;
Endoscopic pancreatic sphincterotomy;
Endoscopic sphincteropapillotomy
- From:
Chinese Journal of Digestive Endoscopy
2017;34(8):554-559
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical efficiency of endoscopic pancreatic sphincterotomy ( EPS) combined with pancreatic duct stent for acute recurrent pancreatitis ( ARP ) caused by biliary microlithiasis. Methods A total of 71 patients were diagnosed as having ARP resulting from biliary microlithiasis from April 2005 to November 2016, and their clinical data were retrospectively analyzed. Patients were divided into two groups according to different endoscopic therapy, EPS ( n=34) and EST group (n=37), respectively. The rate of pancreatitis recurrence, post-ERCP pancreatitis (PEP) and biliary complications were compared by Chi-square test and the influencing factors of recurrence were evaluated by survival analysis. Results The follow-up time ranged from 2 to 108 months ( median 21. 5 months) in EPS group and ranged from 5 to 120 months ( median 39 months) in EST group. Twelve months after endoscopic therapy, 2 patients in EPS group and 5 in EST group suffered recurrent pancreatitis(χ2=0. 461, P=0. 497). Recurrence occurred in 13 patients in 60 months after endoscopic therapy, 4 patients in EPS group and 9 in EST group. Cox regression analysis indicated different endoscopic treatment ( RR=6. 808, 95%CI: 1. 389-33. 356, P=0. 018) and type 2 diabetes ( RR=0. 134, 95%CI:0. 029-0. 608, P=0. 009) were statistically significant factors. There were no significant difference in incidence of PEP (20. 6% in EPS group, 10. 8% in EST group,χ2=1. 294, P=0. 255) and biliary complications between two groups (11. 8% in EPS group, 24. 3% in EST group, χ2=1. 869, P=0. 172). Conclusion EPS combined with pancreatic stenting is effective for acute recurrent pancreatitis caused by microlithiasis. Type 2 diabetes may also lead to recurrence of acute pancreatitis.
