Risk Analysis Of ERCP In Patients With Billroth ? Gastrectomy

Objective: This study retrospectively analyzed and summarized the 150 cases of ERCP,to explore the feasibility and safety of ERCP in patients with Billroth? gastric resection.Methods: This study collects and analyzes the clinical data of 150 patients underged ERCP from January 1,2016 to December 31,2018 in the first affiliated hospital of Hunan Normal University,in order to compare and analyze:(1)Based on the previous history of Billroth? gastrectomy,divided into Billroth ? gastrectomy goup(n=48)and normal gastrointestinal group(n=102),the success rate of ERCP was analyzed in terms of gender,age,history of major gastric resection,stone size,number of stones,combined pancreatitis or AOSC or chronic disease before ERCP.(2)Based on the previous history of Billroth? gastrectomy,divided into Billroth? gastrectomy group(n=48)and normal gastrointestinal group(n=102),the probability of total complications and the common complications of postoperative after ERCP in the Billroth? gastrectomy group and normal gastrointestinal group was analyzed and compared.(3)In the Billroth? gastrectomy group(n=48),according to the diameter of the stone,the number of the stone,whether combined pancreatitis or AOSC or chronic disease before ERCP,there analyses thesuccess rate of ERCP and the factors associated with postoperative complications of ERCP.Results:1.In the 150 cases,the success rate of ERCP in the Billroth ?gastrectomy goup,the large stone group and the multiple stone group was lower than that of the normal gastrointestinal anatomy group,the small stone group and the single stone group(P<0.05).There was no significant difference in the success rate of ERCP between the gender,age,preoperative pancreatitis or AOSC and preoperative chronic disease group(P>0.05).2.The incidence of total complication after ERCP in the Billroth ?gastrectomy goup was higher than that of the normal gastrointestinal anatomy group(P<0.05).However,there was no significant difference in the rate of incidence of common complications(high amylase,pancreatitis,infection,bleeding)(P>0.05).3.Among the patients in the Billroth? gastrectomy goup,the success rate of ERCP was in the large stone group lower than that of the in the small stone group(P<0.05);the rate of incidence of postoperative complications of ERCP in the large stone group was higher than that in the small stone group(P<0.05).4.Among the patients in the Billroth? gastrectomy goup,the rate of incidence of postoperative complications of ERCP in the multiple stonegroup was higher than that in the single stone group(P<0.05).However,there was not significantly different in the success rate of ERCP between the two groups(P>0.05).5.Among the patients in the Billroth? gastrectomy goup,the incidence of postoperative complications of ERCP in the combined pancreatitis or AOSC group was higher than that in the non-consolidated group(P<0.05).However,the success rate of ERCP was not significantly different between the two groups(P<0.05).6.Among the patients in the Billroth? gastrectomy goup,the rate of incidence of postoperative complications of ERCP in the combined chronic disease group was higher than that in the non-consolidated group(P<0.05).However,the success rate of ERCP between the two groups was not significantly different(P>0.05).Conclusion:1.The success rate of ERCP in patients with Billroth? gastrectomy was lower than that in the normal gastrointestinal anatomy,and the incidence of postoperative complications was higher than that in the normal gastrointestinal anatomy group.This may be caused by postoperative gastrointestinal tract.After reconstruction,the anatomical structure changed,making it more difficult to perform endoscopic retrograde cholangiopancreatography.2.The size of the stone can affect the success rate of ERCP inpatients with Billroth? gastrectomy,this may be related to the treatment of "difficult stones",which increases the difficulty of ERCP.3.The size of the stones,the number of stones,preoperative pancreatitis or AOSC,and preoperative chronic disease can affect the postoperative complications of ERCP in patients with Billroth? gastrectomy.