中国实用外科杂志2024，Vol.44Issue(10)：1165-1170,6.DOI:10.19538/j.cjps.issn1005-2208.2024.10.17
内镜下逆行胰胆管造影术后非结石性急性胆囊炎风险因素分析
Study on risk factors of post-endoscopic retrograde cholangiopancreatography acalculous acute cholecystitis
摘要
Abstract
Objective To analyze the influencing factors and temporal characteristics of post-endoscopic retrograde cholangiopancreatography acalculous acute cholecystitis(PEAAC)occurring after endoscopic retrograde cholangiopancreatography(ERCP).Methods A retrospective analysis was conducted on the clinical data of 886 patients treated with ERCP for common bile duct stones at the Department of General Surgery,the First Hospital of Lanzhou University,from January 2017 to December 2019.Patients were divided into the PEAAC group(70 cases)and the non-PEAAC group(816 cases)based on the occurrence of PEAAC.Logistic regression analysis was used to identify the risk factors for PEAAC following ERCP.The relationship between the Li-Tanaka classification of peripapillary diverticula(PAD)and the onset of PEAAC,as well as the time characteristics of PEAAC onset post-surgery,were also analyzed.Results Univariate analysis showed statistically significant differences in mechanical lithotripsy,endoscopic retrograde biliary drainage with plastic stent placement(ERBD),endoscopic papillary balloon dilatation(EPBD),endoscopic nasobiliary drainage(ENBD),PAD,gallbladder wall roughening,elevated white blood cell count(WBC),alanine aminotransferase(ALT),increased neutrophil percentage,triglycerides(TG),cholesterol(CHOL),hyperamylasemia,and CA19-9(P＜0.05).Multivariate analysis indicated that mechanical lithotripsy,ERBD,PAD,gallbladder wall roughening,hyperamylasemia,and elevated CA19-9 were independent risk factors for PEAAC.In the Li-Tanaka classification of PAD,the incidence of PEAAC in patients with type Ⅰ and type Ⅱ a PAD is 51.7％.The incidences of PEAAC at different time intervals post-ERCP are as follows:22 cases(2.5％)within 15 days,12 cases(1.4％)between 15 to 30 days,11 cases(1.2％)between 30 to 45 days,9 cases(1.0％)between 45 to 60 days,9 cases(1.0％)between 60 to 75 days,and 7 cases(0.8％)between 75 to 90 days.Conclusion Mechanical lithotripsy,ERBD,PAD,gallbladder wall roughening,hyperamylasemia,and elevated CA19-9 are independent risk factors for the occurrence of PEAAC and have significant clinical value in predicting PEAAC.Within one month after ERCP,patients with these risk factors should be closely monitored and managed.关键词
内镜逆行胰胆管造影术/急性非结石性胆囊炎/壶腹周围憩室/危险因素Key words
endoscopic retrograde cholangiopancreatography/acute acalculous cholecystitis/peripapillary diverticula/risk factors分类
医药卫生引用本文复制引用
刘振,张旭,张保平,赵进玉,金伯儒,钟汝阳,林延延,岳平,孟文勃..内镜下逆行胰胆管造影术后非结石性急性胆囊炎风险因素分析[J].中国实用外科杂志,2024,44(10):1165-1170,6.基金项目
甘肃省联合科研基金重大项目(No.23JRRA1488) （No.23JRRA1488）
