Clinical research on the prophylactic effects of pancreatic duct stenting combined with non-storied anti-inflammatory drug on post endoscopic retrograde cholangiopancreatography pancreatitis in difficult bile duct cannulation
10.3969/j.issn.1009-0754.2017.05.010
- VernacularTitle:胰管支架置入联合吲哚美辛栓纳肛预防困难胆管插管患者逆行胰胆管造影术后胰腺炎的临床研究
- Author:
Guangyong WANG
1
;
Yunxing SHI
;
Guozhong ZHOU
;
Jiao LYU
;
Hui QIAN
;
Xiaohong ZENG
;
Lingxia LI
;
Changqin GUO
Author Information
1. 解放军第四一一医院消化内科
- Keywords:
Indomethacin;
Endoscopic retrograde;
Pancreatic duct stent;
Post endoscopic retrograde cholangiopancreatogra-phy pancreatitis
- From:
Journal of Navy Medicine
2017;38(5):414-417
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the prophylactic effects of pancreatic duct stenting (PDS) combined with non-storied anti-inflammatory drug (NSAID) on post endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) in difficult bile duct cannulation .Methods One hundred and eight patients who experienced difficult bile duct cannulation during hospitalization from January 2012 to November 2016 in the Department of Gastroenterology of the hospital were enrolled for the study .The patients were ran-domly divided into 4 groups:i.e.Group A that underwent simple PDS , Group B that received NSAID , Group C that were treated with PDS combined with NSAID and Group D that had routine ERCP without preventive measures for PEP .The levels of serum amylase be-fore surgery, 4 and 24 hours after ERCP were observed closely .The scores of abdominal pain were evaluated by VAS method , and the levels of serum amylase , the rate of post ERCP and scores of abdominal pain after ERCP were compared between the 4 groups.Results Four hours after ERCP, serum amylase levels of group B and group C were all significantly lower that those of group D (P<0.05). Serum amylase levels of group A, B and C 24 hours after ERCP were all significantly lower that those of group D (P<0.05).The rate of PEP 24 hours after ERCP for group A and C was 0%, which was obviously lower than that of group D (7.4%)(P<0.05).The VAS scores of various groups 4 and 24 hours after ERCP were significantly higher than that before ERCP (P<0.05).The VAS scores of groups B and C 4 and 24 hours after ERCP were all significantly higher than that of group D (P<0.05), and the VAS scores of group B 4 and 24 hours after ERCP was obviously lower than that of group A (P<0.05).Only at hour 24 after ERCP, the VAS pain scores of group A were higher than that of group D (P<0.05).Conclusion After ERCP, pancreatic duct stenting combined with non-storied anti-inflammatory drug could reduce the rates of hyperamylasemia and PEP , as well as the scores of abdominal pain scores after ERCP, and also could effectively prevent the incidence of pancreatitis after PEP .
