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Current approaches in management of post-ERCP complicationsстатья Тезисы
Статья опубликована в высокорейтинговом журнале
Статья опубликована в журнале из списка Web of Science и/или ScopusДата последнего поиска статьи во внешних источниках: 8 сентября 2021 г.
- Авторы: Shapovalianz Sergey, Budzinsky Stanislav, Fedorov Evgenii, Zakharova Mariya, Chernyakevich Pavel, Platonova Elena
- Журнал: Digestive Endoscopy
- Том: 32
- Номер: S1
- Год издания: 2020
- Издательство: Blackwell Publishing Inc.
- Местоположение издательства: United Kingdom
- Первая страница: 100
- Аннотация: Aims: To evaluate the results in treatment of post‐ERCP complicaions.Methods: The retrospective cohort single center study was held at the Pirogov Russian Medical University. The complications of endoscopic transpapillary interventions occurred at the Moscow City Hospital #31, Moscow, Russian federation, during the period from January 1st 2008 to 01.01 January 1st 2019 were analized.Generally, there were 5701 endoscopic transpapillary interventions. The general complication rate was 1.5% (86 pts), mortality rate – 0.24% (14 pts). Post‐endoscopic papillotimy (EPT) bleeding occurred in 13 (0.22%) cases, post‐ERCP pancreatitis (PEP) – in 49 (0.85%) cases and perforation – in 24 (0.42%) cases.Results: Combined endoscopic hemostasis was performed in all 13 cases of post‐EPT bleeding by the epinephrine infiltration of the EPT margins and focal electrocoagulation of bleeding source.Main pancreatic duct stenting was undertaken in 29 (59.2%) cases with technical success in 27 (93.1%) cases and clinical success in 26 (89.7%) cases. There were 1 (3.4%) case of PEP progression and death in stenting group. The mortality rate in non‐stenting group was 25% (5/20).An endoscopic treatment of ERCP‐perforation was undertaken in 16 (66.67%) of 24 observations with success in 15 (93.75%) cases with mortality rate 6.25%. There were no deaths in the group of conservative treatment of ERCP‐perforation (3 patients), while the mortality rate in surgically treated group was 80% (4/5). Thus, the mortality rate in retroduodenal perforation group was a 20.8% (6/24).Conclusions: Treatment of patients with ERCP‐associated complication more often is lengthy, time‐consuming and expensive. Each endoscopist should keep in mind all possible risk factors, clearly define the indications for ERCP, strictly follow the technique of procedure to reduce the complication rate. We believe it is necessary to eliminate the complications after ERCP by endoscopic method, because surgery leads to a higher postoperative mortality and increases the duration and cost of treatment.
- Добавил в систему: Федоров Евгений Дмитриевич