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Abstract：
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP), with its clinical ad-vantages of less trauma and faster recovery, has become the primary treatment for choledocholithiasis.
OBJECTIVE: To investigate the effects of different ERCP procedures on the sphincter of Oddi.
METHODS: The clinical data of 91 patients who underwent ERCP at Yixing Hospital of Traditional Chinese Medicine between February 2018 and February 2021 were analyzed retrospectively. The patients were divided into endoscopic sphincterotomy (EST, n = 24) and endoscopic papillary balloon dilation (EPBD, n = 67) groups. The duration of operation, pancreatic development, pancreatic sphincterotomy, intubation difficulties, stone recurrence, and incidence of reflux cholangitis and cholecystitis were statistically analyzed in patients with a history of choledocholithiasis, pancreatitis, and Oddi sphincter dysfunction in the EST and EPBD groups.
RESULTS: Differences in hypertension, diabetes, increased bilirubin, small diameter of the common bile duct, or ampullary diverticulum between the two groups were not significant. Statistically significant differences were observed between the two groups concerning sex and age (< 60 years). Patients with a history of choledocholithiasis, pancreatitis, and Oddi sphincter dysfunction were higher in the EST group than in the EPBD group. The number of cases of pancreatic development, pancreatic duct sphincterotomy, and difficult intubation were higher in the EST group than in the EPBD group. The number of Oddi\'s sphincter manometries, ERCP surgical outcomes, and guidewires entering the pancreatic duct several times in EST group were lower than those in the EPBD group. The numbers of stone recurrences, reflux cholangitis, and cholecystitis were higher in the EST group than in the EPBD group.
CONCLUSIONS: In summary, common bile duct stones, pancreatitis history, and multiple guided wire introductions into the pancreatic duct are independent risk factors for EST and EPBD. Based on this evidence, this study can provide actionable insights for clinicians and researchers.
OBJECTIVE: To investigate the effects of different ERCP procedures on the sphincter of Oddi.
METHODS: The clinical data of 91 patients who underwent ERCP at Yixing Hospital of Traditional Chinese Medicine between February 2018 and February 2021 were analyzed retrospectively. The patients were divided into endoscopic sphincterotomy (EST, n = 24) and endoscopic papillary balloon dilation (EPBD, n = 67) groups. The duration of operation, pancreatic development, pancreatic sphincterotomy, intubation difficulties, stone recurrence, and incidence of reflux cholangitis and cholecystitis were statistically analyzed in patients with a history of choledocholithiasis, pancreatitis, and Oddi sphincter dysfunction in the EST and EPBD groups.
RESULTS: Differences in hypertension, diabetes, increased bilirubin, small diameter of the common bile duct, or ampullary diverticulum between the two groups were not significant. Statistically significant differences were observed between the two groups concerning sex and age (< 60 years). Patients with a history of choledocholithiasis, pancreatitis, and Oddi sphincter dysfunction were higher in the EST group than in the EPBD group. The number of cases of pancreatic development, pancreatic duct sphincterotomy, and difficult intubation were higher in the EST group than in the EPBD group. The number of Oddi\'s sphincter manometries, ERCP surgical outcomes, and guidewires entering the pancreatic duct several times in EST group were lower than those in the EPBD group. The numbers of stone recurrences, reflux cholangitis, and cholecystitis were higher in the EST group than in the EPBD group.
CONCLUSIONS: In summary, common bile duct stones, pancreatitis history, and multiple guided wire introductions into the pancreatic duct are independent risk factors for EST and EPBD. Based on this evidence, this study can provide actionable insights for clinicians and researchers.
摘要：
背景：内镜逆行胰胆管造影术（ERCP），具有创伤更小、恢复更快的临床优势，已成为胆总管结石的主要治疗方法。
目的：探讨不同ERCP方法对Oddi括约肌的影响。
方法：回顾性分析2018年2月至2021年2月宜兴市中医医院行ERCP的91例患者的临床资料。将患者分为内镜括约肌切开术（EST，n=24）和内窥镜乳头球囊扩张术（EPBD，n=67)组。操作的持续时间，胰腺发育,胰腺括约肌切开术,插管困难,结石复发,并对有胆总管结石病史的患者进行统计学分析,胰腺炎,EST和EPBD组的Oddi括约肌功能障碍。
结果：高血压的差异，糖尿病,胆红素升高,胆总管直径小，或壶腹憩室两组间无显著性差异。两组在性别和年龄（<60岁）方面具有统计学上的显着差异。有胆总管结石病史的患者，胰腺炎,EST组Oddi括约肌功能障碍高于EPBD组。胰腺发育的病例数，胰管括约肌切开术,EST组插管困难率高于EPBD组。Oddi括约肌测数,ERCP手术结果,EST组多次进入胰管的导丝低于EPBD组。石头复发的数量，反流性胆管炎,EST组胆囊炎发生率高于EPBD组。
结论：总之，胆总管结石,胰腺炎病史,胰管内多根导丝是EST和EPBD的独立危险因素。根据这些证据,这项研究可以为临床医生和研究人员提供可操作的见解.
目的：探讨不同ERCP方法对Oddi括约肌的影响。
方法：回顾性分析2018年2月至2021年2月宜兴市中医医院行ERCP的91例患者的临床资料。将患者分为内镜括约肌切开术（EST，n=24）和内窥镜乳头球囊扩张术（EPBD，n=67)组。操作的持续时间，胰腺发育,胰腺括约肌切开术,插管困难,结石复发,并对有胆总管结石病史的患者进行统计学分析,胰腺炎,EST和EPBD组的Oddi括约肌功能障碍。
结果：高血压的差异，糖尿病,胆红素升高,胆总管直径小，或壶腹憩室两组间无显著性差异。两组在性别和年龄（<60岁）方面具有统计学上的显着差异。有胆总管结石病史的患者，胰腺炎,EST组Oddi括约肌功能障碍高于EPBD组。胰腺发育的病例数，胰管括约肌切开术,EST组插管困难率高于EPBD组。Oddi括约肌测数,ERCP手术结果,EST组多次进入胰管的导丝低于EPBD组。石头复发的数量，反流性胆管炎,EST组胆囊炎发生率高于EPBD组。
结论：总之，胆总管结石,胰腺炎病史,胰管内多根导丝是EST和EPBD的独立危险因素。根据这些证据,这项研究可以为临床医生和研究人员提供可操作的见解.
