Risk Factors Of Post-endoscopi Cretrograde Cholangio Pancreatogaraphy Pancreatitis And Prevention Strategy

Risk factors of post-endoscopic retrograde cholangiopancreatogaraphy pancreatitis and prevention strategyObjectiveObjective to analysis the risk factors of post-endoscopic retrograde cholangiopanc- reatogaraphy pancreatitis and its prevention strategyMethods332 patients who were underwent endoscopic retrograde cholangiopancreatography (ERCP)from Juanuary in 2006 to December in 2007 were analyzsed retropectively,to explore the risk factors of PEP and its prevention strategy.ResultsThere are 332 patients were underwent ERCP(including 171 patients who were intravenous anesthesia).305 patients received endoscopic retrograde cholangio- pancreatography,the incidence of successful intubation was 91.87% (305/332). 22 patients suffered from PEP, amount to 6.63% of all.15 patients failed in intubation of bile duct,the morbidity rate was 26.6%; 8 patients recived endoscopic retrograde cholangiopancreatography in the operation, half of them were attacked by PEP; 13 patients had diverticula beside Vater's diverticula,amount to 10.6%(13/146) of all.The factors referred above had significant difference to matched group(p<0.05).While wether patients under endoscopic sphincteropatllotomy(EST),the onset age,ductal dilatation, intravenous anesthesia and sex or not seemed to have no difference to matched group(p>0.05).Patients who were under the strategy of prophylactic use of octreotide and gabexate, the respectively morbidity rate was 3.21%, 3.92%;24.3% of patients who had no prophylactic use of medicine got PEP in the end;5 in patients underwent endoscopic nasobiliary drainage(ENBD) contracted PEP;84 patients received endoscopic retrograde bile and pancreatic duct drainage,3 of them suffered from PEP。Prevention strategy involved above have significant difference to matched group(p<0.05).Conclutions:1.The risk factors of PEP are pancreative duct opacification, failure intubation of bile duct, jaundice,total time of operation, qualification of operator and the presence of diverticula beside Vater's diverticula. In another way, endoscopic sphinctero- patllotomy(EST),the onset age,ductal dilatation, intravenous anesthesia and sex are seemed to have little relation to significance of PEP(p>0.05).2.Strategys of improving comprehensive qualities of operators,shortening time of whole operation, prophylactic use of octreotide and gabexate, bile and pancreative duct drainage operations(including endoscopic retrograde bile duct drainage, endoscopic nasobiliary drainage,ENBD and pancreativ duct drainage) and controlling the inflammation of diverticulab beside Vater's diverticulacan decrease the incidence of PEP(p<0.05).