Complications of ERCP: a prospective study
Complications of ERCP: a prospective study
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DOI：
10.1016/s0016-5107(04)02169-8
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发表时间：
2004-11-01
影响因子：
7.7
通讯作者：
Rosenberg, J
中科院分区：
文献类型：
--
作者：
Christensen, M;Matzen, P;Rosenberg, J
背景ERCP相关发病率的研究很少包括充分的患者随访。本研究的目的是表征和评估并发症的频率，心肺不良事件，特别是。方法：所有患者接受ERCP在2年的时间被列入这项前瞻性研究。并发症进行了评估，在ERCP的时间，并通过邮政/电话联系后30-daysofprocedure.Results：共1177 ERCP被纳入分析，其中56.2%是治疗。30天并发症发生率为15.9%;手术相关死亡率为1.0%。ERCP术后胰腺炎发生率为3.8%（3例死亡）。出血或穿孔发生率分别为0.9%和1.1%（3例死亡）。1例导致患者死亡的穿孔发生在植入内假体后。5%的ERCP手术发生胆管炎（3例死亡）。呼吸道并发症发生率为2.3%（2例死亡）。多变量分析显示，胆管扩张（p = 0.0001）、支架置入（p = 0.001）和使用超过40 mg东莨菪碱-N-丁基溴化铵（p < 0.05）是并发症的危险因素。胰腺炎的风险随着年龄的增加而增加（p = 0.0078），支架的放置（p = 0.031），胆管扩张（p = 0.036）。结论：这项前瞻性研究证实，ERCP包括治疗程序的并发症发生率很高。心脏病并发症并不像预期的那样常见，尽管这是研究的重点。
Background. Studies of ERCP-related morbidity seldom include a sufficient patient follow-up. The aim of this study was to characterize and to evaluate the frequency of complications, cardiopulmonary untoward events in particular.Methods: All patients undergoing ERCP during a 2-year period were included in this prospective study. Complications were assessed at the time of ERCP and by postal/telephone contact at 30-days after the procedure.Results: A total of 1177 ERCPs were included in the analysis, of which 56.2% were therapeutic. The 30-day complication rate was 15.9%; the procedure-related mortality rate was 1.0%. Post-ERCP pancreatitis occurred in 3.8% of patients (3 deaths). Hemorrhage or perforation occurred with 0.9% and 1.1%, respectively, of the procedures (3 deaths). One perforation that resulted in the death of the patient occurred after placement of an endoprosthesis. Cholangitis occurred in relation to 5% of the ERCP procedures (3 deaths). Cardiorespiratory complications occurred in 2.3% (2 deaths). Dilated bile duct (p = 0.0001), placement of stent (p = 0.001), and use of more than 40 mg of hyoscine-N-butyl bromide (p < 0.05) were risk factors for complications by multivariate analysis. Risk of pancreatitis was increased with age under 40 years (p = 0.0078), placement of stent (p = 0.031), and a dilated bile duct (p = 0.036).Conclusions: this prospective study confirms that the complication rate of ERCP including therapeutic procedures is high. Cardiopulmonary complications were not as common as expected, despite being the special focus of the study.