Analysis Of Common Features Of ERCP Surgery In Patients With Liver Cirrhosis

Objective:To analyze and summarize the 2160 cases of therapeutic ERCP,explore the effect of cirrhosis patients on ERCP and common postoperative complications and success rate.Methods:A retrospective analysis of the clinical data of 2160 patients undergoing ERCP from January 1,2016 to January 1,2018 in Hunan Provincial People's Hospital conducted statistical analysis:?According to whether there is cirrhosis,divided into cirrhosis group(n = 228)and non-cirrhosis group(n = 1932),the prevalence of biliary and pancreatic diseases in patients with cirrhosis and non-cirrhosis was calculated and compared.The common complications of ERCP after two groups were counted:post-ERCP pancreatitis(PEP),hyperamylasemia,hemorrhage,incidence of biliary tract infection,perforation,and success rate of ERCP.Analysis and comparison were performed.? In the cirrhosis group,the etiology of cirrhosis was classified as viral(n=41),alcoholic(n=14),biliary(n=141),and other types(n=32)Four subgroups.The incidence of biliary and pancreatic disease before ERCP and the incidence of common complications after ERCP were calculated for different subgroups and compared with each other.?In the liver cirrhosis group,the severity of hepatic insufficiency was divided into two groups.One group was decompensated liver cirrhosis group,and the other group was decompensated liver cirrhosis group.Child grading was performed according to the Child-Pugh score table,in which ChildA-class patients were in one group(n=127),and ChildB-and C-grade patients were in two groups(n=101).The incidence of biliary and pancreatic diseases before ERCP,the success rate of ERCP,and the incidence of common postoperative complications were compared between the two groups.?In all patients included in this study,according to the history of patients with biliary surgery,divided into biliary surgery history group(n = 109)and no biliary surgery history group(n = 2051)two groups,comparison of the success rate of ERCP and the incidence of common complications after ERCP between two groups.? In all patients included in this study,according to the presence or absence of ascites,they were divided into ascites group(n=63)and non ascites group(n=2097).The difference between the ERCP success rate and the postoperative complication rate between the two groups was compared.Results:1.The incidence of biliary stones,cholecystolithiasis,common bile duct stones,suppurative cholangitis,and acute pancreatitis in the cirrhosis group was higher than that in the non-cirrhotic group.The difference was statistically significant(P<0.05).The incidence of common complications after ERCP was higher in the cirrhotic group than in the non-cirrhotic group.The difference was statistically significant(P<0.05).Among them,the risk of hyperamylasemia and biliary tract infection was mainly increased.Statistically significant(P<0.05).The success rate of ERCP was 96.5%in the cirrhotic group and 96.7%in the non-cirrhotic group.There was no significant difference between the two groups.2.There were no statistically significant differences in the incidence of biliary stones,suppurative cholangitis,and acute pancreatitis in the four subgroups of viral,alcoholic,biliary,and other types.The incidence of common complications after ERCP in the virus group was higher than the other three subgroups,and the difference was statistically significant(P<0.05).3.The incidence of gallstones in decompensated cirrhosis group was higher than that in compensated cirrhosis group(94.1%vs 83.5%),and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of suppurative cholangitis and acute pancreatitis between the two groups.The incidence of common complications after ERCP was higher in decompensated cirrhosis group than in compensated cirrhosis group(28.7%vs 17.3%),and the difference was statistically significant(P<0.05).The success rate of ERCP in the compensated cirrhosis group was higher than that in the decompensated cirrhosis group(96.9%vs 96.0%),but the difference was not statistically significant.4.The success rate of ERCP intubation in the history group without biliary surgery was higher than that in the history group with biliary surgery(96.9%vs 92.7%),and the difference was statistically significant(P<0.05).The incidence of common complications after ERCP was similar between the two groups(15.6%in the history group and 15.0%in the history group without biliary surgery),and the difference was not statistically significant.5.The incidence of common complications after ERCP in ascites group was higher than that in nonascitic fluid group(25.4%vs 14.7%),and the difference was statistically significant(P<0.05).The success rate of ERCP was higher in non-ascites group than in ascites group(96.8%vs 93.7%),but the difference was not statistically significant.Conclusion:1.The incidence of gallstones,gallstones,common bile duct stones,suppurative cholangitis,and acute pancreatitis was higher in patients with cirrhosis than in non-cirrhotic patients.The incidence of common complications after ERCP was high,with hyperamylasemia and The risk of biliary tract infections is mainly increased,and the number of cases of perforation and hemorrhage is small.This is mainly related to the method of sphincter expansion,but it does not affect the success rate of ERCP.2.Viral cirrhosis increases the risk of common complications after ERCP but does not affect the success rate of ERCP.3.Patients with decompensated liver cirrhosis have a higher incidence of gallstones than compensated patients with cirrhosis.The incidence of common complications after ERCP is high,but there is no significant difference in the success rate of ERCP.4.The success rate of ERCP intubation in patients undergoing biliary surgery was low,but it did not increase the incidence of common complications after ERCP.5.The presence of ascites increases the risk of common complications after ERCP,but there is no significant difference in the success rate of ERCP compared with non-ascites patients.