Clinical Study On The Preventive Effect Of Local Spraying Epinephrine On Hyperamylasemia And Pancreatitis After ERCP

Objective To study the preventive effect of local spraying epinephrine on PEHA(Post-ERCP hyperamylasemia)and PEP(Post-ERCP pancreatitis,PEP)after ERCP(Endoscopic Retrograde Cholangiopancreatography,ERCP),and the effect of local spraying of epinephrine on the severity of PEP.Methods According to the inclusion criteria and exclusion criteria,358 inpatients who needed ERCP treatment in the Center of Digestive Medicine of the Second Affiliated Hospital of Nanjing Medical University from October 2017 to June 2018 were selected.The patients were randomized double-blind divided into two groups: the experimental group of local spraying epinephrine on the duodenal papilla and the control group of the local spraying on saline.The occurrence and severity of PEHA,PEP were analyzed prospectively,and the intraoperative situation was recorded in detail at 3 hours after operation,12 hours and 24 hours amylase levels,compared the incidence of PEHA and PEP between the two groups,and the severity of PEP was compared.Results The levels of amylase in the experimental group of local spraying epinephrine on the duodenal papilla for 3 hours,12 hours and 24 hours were lower than those in the control group.The incidence of PEHA in the experimental group was 28.7% < that in the control group(49.4%,P < 0.05).PEP occurred in 3 cases(1.6%),1 case(0.6%)in the experimental group,8 cases(4.4%)in the control group and 2 cases(1.2%)in the control group.There was no severe PEP in both groups.The incidence of PEP in the experimental group(2.2%)was lower than that in the control group(5.6%),(P >0.05).Conclusion:Local injection of epinephrine on papilla can reduce serum amylase level in the same period after operation,prevent the occurrence of PEHA and reduce the occurrence of PEP,but the effect of preventing PEP needs further study.