내시경적 역행성 췌담관 조영술후 췌장염 발생에 대한 임상적 고찰 = Biliary Tract & Pancreas;Clinical Study of Endoscopic Retrograde Cholangiopancreatography (ERCP) Induced Pancreatitis

다국어 초록 (Multilingual Abstract)

Background/Aims: Pancreatitis is one of the major complications of ERCP. The purpose of this study is to evaluate the incidence rate and risk factors of ERCP- induced pancreatitis.
Method: We analysed 99 consecutive patients(45 males and 44 females) undergoing ERCP from March to September, 1994. The level of serum amylase was measured and clinical assessment of pancreatitis was performed before, 24 hour, 48 hour, and 72 hour after ERCP. We defined clidical pancreatitis as combination of elevated amylase level over 2 days with abdomial pain and tenderness.
Reaults: ① Fifty eight patients(58.6%) underwent ERCP for diagnosis, and 32 patients(32.3%) for therapy including endoscopic sphincterotomy(EST), endoscopic nasobiliary drainage(ENBD), or endoscopic retrograde biliary drainage(ERBD). The failure rate of the ERCP was 9 percent(9 patients). ② Underlying diseases were 64 biliary stone cases(71.1%), 15 malignant cases, and other 11 cases. ③ There were 3 ERCP-induced pancreatitis cases(3%) including 2 mild cases and t severe case leading to sepsis and death. C)ther ERCP-induced complication included hemorrhage. ④ The patient group who underwent therapeutic ERCP including EST, ENBD, or ERBD, showed significantly higher rate(9.4%) of complication than the group who underwent diagnostic ERCP(0%)(P$lt;0.01). Age, gender, periampullary diucticolon, the kinds of underlying disease, or the connulation of pancreatic duct showed no significant effect on the incidence rate(P$gt;0.05).
Conclusion: The incidence rate and risk factor of ERCP-induced pancreatitis were 3 percent and therapeutic ERCP, respectively. There were no other risk factors. ERCP seldom induces clinical problems if performed by an expert endoscopist with cauxion. However, since a severe complication may cause death, careful monitoring is required for patients undergoing ERCP.