ERCP‐Induced Acute Necrotizing PancreatitisIs It a More Severe Disease?
作者:
Anthony Fung,
Gregory Tsiotos,
Michael Sarr,
期刊:
Pancreas
(OVID Available online 1997)
卷期:
Volume 15,
issue 3
页码: 217-221
ISSN:0885-3177
年代: 1997
出版商: OVID
关键词: Endoscopic retrograde cholangiopancreatography;Complications;Necrotizing pancreatitis;Infection;Severity;Outcome
数据来源: OVID
摘要:
Acute necrotizing pancreatitis (ANP) is an uncommon but serious complication of endoscopic retrograde cholangiopancreatography (ERCP). This study compares the severity, clinical course, and long-term outcome of ERCP-induced ANP with ANP induced by other causes. A review of 72 consecutive patients with ANP treated surgically at the Mayo Clinic identified ERCP as the cause in 6 patients (8%). Compared to the remaining 66 patients, the post-ERCP group had higher APACHE II scores on admission (mean, 13 vs. 10) and more extensive pancreatic necrosis (mean, 55 vs. 47%). The post-ERCP group had a higher rate of infected necrosis (100 vs. 75%) and required earlier necrosectomy after the onset of pancreatitis (9 vs. 13 days). The rate of postoperative pancreatic and enteric fistulae was also higher (50 vs. 33%). Although the mortality rate in the post-ERCP group was lower (17 vs. 29%), they were significantly younger (50 vs. 62 years;p= 0.02) and all the survivors had residual long-term morbidity. ANP is more severe when ERCP-induced; infection introduced during the ERCP may, in part, account for this severity.
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