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The Investigation of the Correlation Factors of Post-ERCP Pancreatitis in Patients Who Had Obstructive Jaundice

Author: XuBo
Tutor: MaShuRen
School: Dalian Medical University
Course: Digestion within the science
Keywords: obstructive jaundice post-ERCP pancreatitis multivariate analysis complication
CLC: R657.51
Type: Master's thesis
Year: 2013
Downloads: 12
Quote: 0
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Abstract


Objective:the aim of this retrospective study was to find protective and riskfactors of post-ERCP pancreatitis in patients who had obstructive jaundice,in order toobtain some guidances for the clinical therapy.Methods:103cases of obstructive jaundice who had undergone endoscopic retrograde cholangiopancreatography (ERCP) in the department of endoscope of Shen yang PLA General hospital from September2011to March2012were analyzed.We diagnosed post-ERCP pancreatitis (PEP) by the followed clinical materials,and the peroperative figures of WBC,hemodiastase,lipase, total bilirubin,and which at3h and24h post-procedure.we recorded these patients’age,gender,clinical diagnoses,height,weight,history of pancreatitis,aim of ERCP,history of EST,diameter of common bile duct(DCBD),time of ERCP, pancreaticography,EST, endoscopicnaso biliary drainage(ENBD),pancreatic internal drainage.The patients was arranged to PEP group and normal group.These potential factors in two groups were undertaken univariate and multivariate analysis.Results:The incidence of PEP in patients who had malignant OJ was18.2%, and the benign one was8.6%;41cases were above60y,and62cases were lower than60y;middle-aged and senium patients,emaciated and normal types inBMI were main portion in these cases,the time of ERCP was discrete; Biliary diseases is the main reason to undergo ERCP,the incidence of PEP in the male was lower than the female;the incidence of PEP in patients who had history of pancreatitis,history of EST,no EST operation, pancreaticography was higher than the opposition (27.3%vs9.9%,13.8%vs7.9%,13.2%vs7.4%,20.7%vs8.1%).But there were no statistical differences between the groups regarding these factors for PEP.Finally enhanced diameter of CBD and ENBD were identified as independent protective factors for PEP in multivariate analysis (DCBD:P=0.046,ENBD:P=0.006). Conclusions: Biliary diseases are always the main part of OJ;the age of mostpatients is above60y,the incidence of PEP in patients who had malignant OJ is higherthan the benign one;Althought female, history of pancreatitis,history of EST,no ESToperation, pancreaticography will increase the possibility of PEP,these are notindependent risk factors for PEP. Enhanced diameter of CBD and ENBD are the finalprotective factors for PEP.

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CLC: > Medicine, health > Surgery > Of surgery > Abdominal surgery > Pancreas > Pancreatitis
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