CONTROLLED TRIAL OF URGENT ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY AND ENDOSCOPIC SPHINCTEROTOMY VERSUS CONSERVATIVE TREATMENT FOR ACUTE-PANCREATITIS DUE TO GALLSTONES
CONTROLLED TRIAL OF URGENT ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY AND ENDOSCOPIC SPHINCTEROTOMY VERSUS CONSERVATIVE TREATMENT FOR ACUTE-PANCREATITIS DUE TO GALLSTONES
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DOI：
10.1016/s0140-6736(88)90740-4
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发表时间：
1988-10-29
期刊：
影响因子：
168.9
通讯作者：
FOSSARD, DP
中科院分区：
文献类型：
--
作者：
NEOPTOLEMOS, JP;LONDON, NJ;FOSSARD, DP
121例被认为是由胆结石引起的急性胰腺炎患者被随机分为急诊内窥镜逆行胰管造影术(ERCP)和内窥镜括约肌切开术(ES)治疗或常规治疗。根据修改后的格拉斯哥系统，他们根据预测的袭击严重程度进行了分层。ERCP在72小时内完成，如果发现胆总管结石，患者立即行ES取石。接受ERCP检查的59例患者中，并发症较少。与常规治疗的62例患者相比，差异仅限于那些预测发作严重的患者(6/25 ERCP+-)。ES[1例死亡]，而常规治疗为17例[5例死亡])。接受ERCP的严重发作患者的住院时间也较短。接受保守治疗的患者的ES天数(中位数为9.5天)高于接受保守治疗的患者(中位数为17.0天)。
121 patients with acute pancreatitis thought to be due to gallstones were randomised to treatment with urgent endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (ES) or with conventional treatment. They were stratified by predicted severity of the attack, according to the modified Glasgow system. ERCP was done within 72 h, and if common bileduct stones were identified, patients underwent ES immediately to extract the stones. There were fewer complications in the 59 patients who underwent ERCP .+-. ES than among the 62 treated conventionally, the difference being confined to those whose attacks were predicted to be severe (6/25 ERCP .+-. ES [1 death] compared with 17/28 conventional treatment [5 deaths]). Hospital stay was also shorter for patients with severe attacks who underwent ERCP .+-. ES than for those who received conservative treatment (median 9.5 versus 17.0 days).