Analysis Of The Related Factors Of Postoperative Operation Of Pancreatitis After ERCP

Background:Endoscopic retrograde cholangiopancreatography(ERCP)is an important diagnosis and treatment method for hepatobiliary and pancreatic diseases.It is a minimally invasive endoscopic intervention for diagnosis and treatment.It has the advantages of less trauma and shorter operation time,and widely used in clinical practice.Despite these advantages,after all,as an invasive procedure,postoperative complications are unavoidable.Pancreatitis is the most common and most serious complication after ERCP.It may even endanger the patient's life.However,its prediction is difficult.It is a disease caused by multiple factors,including patient factors,and also includes operations.Related factors and the operator's operating level factors.Although with the continuous improvement of ERCP indications,the continuous innovation and development of operating equipment,the gradual standardization of operating procedures,and the gradual maturity of operating techniques,no matter whether it is diagnostic or therapeutic ERCP operation,postoperative pancreatitis still exists.To a great extent,they have hindered the wide application in a lot of hospital.Purpose:In order to further investigate the risk factors of pancreatitis after ERCP,the relevant factors of surgical operation of pancreatitis after ERCP were retrospectively analyzed to provide the basis for preventing the occurrence of pancreatitis.Method:A total of 366 cases of operation video data and clinical data of patients undergoing ERCP from January 2010 to June 2013 in our hospital were selected.According to a certain selection and exclusion criteria,relevant surgical operation factors,clinical data,and postoperative concurrency were summarized and analyzed.Pancreatitis was statistically analyzed.Result:1.Of the 366 patient data samples studied,276 were included in the study according to the inclusion criteria and exclusion criteria.32 of 276 clinical cases had postoperative pancreatitisand the probability of postoperative pancreatitis was 11.6%,Among them by low qualification of implementation of the 120 cases,23 cases with postoperative pancreatitis,postoperative pancreatitis probability is 19.2%,high qualification of operation in 156 cases,9 cases of PEP,postoperative pancreatitis probability is 5.77%.2.Results of single factor analysis: According to Table 1,the number of times the cannula touched the duodenal papilla,the force of the cannula touching the duodenal papilla,the time of intubation into the commonbile duct,the number of times of entering the pancreatic duct,and the pancreaticography times and length of pancreaticography were associated with the occurrence of pancreatitis after ERCP.Other factors were not related significantly.3.Results of multivariate analysis: According to Table 2,the number of times of touching the duodenal papilla,the force of the touched duodenal papilla,the time of intubation into the common bile duct,and length of pancreaticography are independent risk factorsfor post-ERCP pancreatitis.4.Factors related to the operator: the incidence of postoperative pancreatitis in the low-aged group was significantly higher than that in the high-aged group(19.2%vs5.77%,P<0.05).Conclusions:1.The incidence of pancreatitis after ERCP and the number of times of intubation and touching the duodenal papilla,the force of the papilla intubation,the time of intubation into the common bile duct,the number of times intubation into the pancreatic duct,the number of times of pancreatic duct development,and length of pancreaticography among them,the number of timesof touching the duodenal papilla,the intensity of touching the duodenal papilla,the time of intubation into the common bile duct,and the development of pancreatic duct are independent risk factors of PEP.2.Gentle ERCP operation,skilled operating practices,to avoid intubation into the pancreatic duct and reduce the number of pancreatic duct angiography,can reduce the incidence of postoperative pancreatitis.3.The risk of postoperative pancreatitis is lower in those with high age than in those with low age.