การทำ ERCP ในประสบการณ์ปีที่ 9 และ 10: ผลแทรกซ้อนและปัจจัยเสี่ยงจากหัตถการ

บทคัดย่อ

Objectives: To evaluate the results of ERCP in Nakhonpathom hospital from October 1st 2009 to September 30th 2011 including its complications and procedure-related risk factors.

Material and methods: Retrospectively collected the data from the procedural ERCP records and searched for the procedural specific complications from patient charts in which the patients could not be discharged after 24 hours.
Diagnosed the conditions into categories according to consensus criteria of American Society of Gastrointestinal Endoscopy and analysed its procedure related risk factors with statistic odds ratio (OR) and 95% confident interval (95% CI)

Results: 452 ERCP were enrolled in this study for the indications of 242 CBD stone (53.53%), 94 obstructive jaundice (27.79%), 57 change & remove stent (12.61%) etc.

There were 93 diagnostic ERCP (20.57%), 308 successful therapeutic ERCP (68.14%) and 51 failed ERCP (11.28%).

17 procedural specific complications (3.76%) were categorized into: 9 post ERCP pancreatitis (PEP) (1.99%), 3 cholangitis (0.66%), 3 nonspecific abdominal pain (0.66%), 1 each hemorrhage and retrieval basket entrapment (0.22%).

There was no complication in 93 diagnostic but 5 in 308 successful therapeutic and 12 in just 51 failed ERCP (1.1% and 2.65%, respectively).

PD cannulation carried the highest risk (OR = 8.64) and precut sphincterotomy (OR = 4.22) was the second.

Conclusion: Overall ERCP in Nakhonpathom hospital is safe and provides good outcomes but still has its risks; PD cannulation and precut sphincterotomy, especially in the failed procedure.