内镜下十二指肠乳头切除术并发症分析

Complication analysis of endoscopic papillectomy for duodenal papilla lesion

  • 摘要: 目的 探讨内镜下十二指肠乳头切除术(endoscopic papillectomy,EP)并发症及相关因素。 方法 回顾性分析2007年1月- 2017年3月在解放军总医院经EP治疗的106例十二指肠乳头病变患者的内镜及临床资料,其中男性70例,女性36例,年龄23 ~ 87(58.8±12.5)岁,根据是否发生并发症分为并发症组和无并发症组。 结果 37例患者发生并发症,EP总并发症发生率为34.90%。术后胰腺炎19例(17.92%)、出血25例(23.58%)、急性胆管炎8例(7.55%)、穿孔3例(2.83%)。多因素分析显示并发症的发生与患者性别、年龄、病理分型、黏膜下注射、乳头切开、完整切除、放置胰胆管支架无相关性,与整块切除及瘤体大小有关。 结论 EP并发症与瘤体大小、整块切除有关,肿瘤直径> 3.0 cm、整块切除并发症发生率高。

     

    Abstract: Objective To evaluate the clinical, endoscopic, and pathological characteristics related to complications of endoscopic papillectomy (EP) for duodenal papilla lesion. Methods The endoscopic and clinical data about 106 cases with duodenal papilla lesion who received EP in Chinese PLA General Hospital from January 2007 to March 2017 were retrospectively analyzed. Of the 106 cases, there were 70 males and 36 females with average age of (58.8±12.5) years (ranging from 23 to 87 years), and they were divided into two groups according to with or without complications. Results Complications occurred in 37 cases with complication rate of 34.90%. There were 19 patients with acute pancreatitis (17.92%), 25 patients with hemorrhage (23.58%), 8 patients with acute cholangitis (7.55%), and 3 patients with perforation (2.83%). The complication occurrence was related to tumor size and en bloc resection, but it was not related to gender, age and final pathology results, complete resection, submucosal injection, endoscopic sphincterotomy and placement of stents. Conclusion The incidence of EP complications is related to tumor diameter and en bloc resection, and it increases when tumor diameters are greater than 3.0 cm or the operation is en bloc resection.

     

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