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Academic Frontiers

ERCP TREATMENT FOR THE ACUTE BILIARY PANCREATITIS


Acute biliary pancreatitis is a disease caused by pancreatic duct obstruction and pancreatic juice spillover. The disease is very common in clinical practice and is one of the causes of acute abdomen. Clinical research shows that over 80% of acute biliary pancreatitis patients are related to alcohol and biliary diseases. The disease develops rapidly, has multiple complications, and can quickly progress to severe pancreatitis, causing serious harm to the human body. In the past, open surgery and internal medicine conservative treatment were commonly used, but with the rapid development of endoscopic medical technology, it has gradually replaced traditional treatment methods. To further understand the clinical effect of ERCP treatmenton acute biliary pancreatitis patients, the treatment results of the observation group are satisfactory, and the research results are described below.


Methods of ERCP treatment for acute biliary pancreatitis
The role of ERCP treatment in acute biliary pancreatitis


Prior to group treatment, all patients were treated with gastric and intestinal decompression and fasting, as well as enteral and parenteral nutrition support, pancreatic enzyme activity inhibition, preservation of water and electrolyte balance, acid suppression, and anti-infection treatment, among others.


The control group only received simple pre-group treatment, including enteral and parenteral nutrition support, pancreatic enzyme activity inhibition, preservation of water and electrolyte balance, acid suppression, and anti-infection treatment, along with gastric and intestinal decompression for patients with abdominal distension and pain and relevant treatments for severe pancreatitis patients. Patients in the observation group received ERCP treatmentas follows:


Preoperative preparation


  • Material preparation: 36% diatrizoate meglumine, nasal biliary drainage tube, zebra wire, stone extraction balloon, stone extraction basket, needle-shaped incision knife, papillotomy knife, and duodenoscope.

  • Routine examination: Iodine allergy test, blood amylase test, liver and kidney function tests, coagulation four-item test, and blood routine examination were performed on the patients.

  • Medication: the patient was given intravenous injection of pethidine 100g, diazepam 10g, and atropine 20mg.


Clinical operation


The endoscope was sent to the duodenum via the oral cavity, and retrograde cholangiopancreatography was performed. Then, the patient's papilla was cut open, and the stone extraction basket was used to retrieve the stones in the patient's body. The stone extraction balloon was then used to clean the patient's bile duct, cleaning about three times. After cleaning, the nasal biliary drainage tube was placed in the patient's body. During clinical operations, clinical conditions such as the biliary duct, stones, and papilla of the patient were recorded, and attention was paid to whether the biliary duct of the patient was narrowed, and the number, size, shape, and distribution of stones in the patient's body were recorded.



Currently, acute biliary pancreatitis has become a very common disease in clinical practice, and the incidence rate of the disease continues to increase with changes in people's dietary habits. Clinical studies show that acute pancreatitis caused by cholelithiasis (biliary pancreatitis) accounts for about 50% of the incidence of all acute pancreatitis. The disease develops rapidly, with multiple complications, and can quickly progress to severe pancreatitis, causing serious harm to the human body. During clinical treatment, surgery and internal medicine conservative treatment were once used, but with the rapid development of endoscopic medical technology, it has gradually replaced traditional treatment methods (open surgery and internal medicine conservative treatment).


ERCP treatmentcan fundamentally treat acute biliary pancreatitis, relieve patient's biliary obstruction, fully drain bile, eliminate bile reflux in the pancreatic duct, and reduce inflammation. In this study, the hospitalization costs, hospitalization days, time for blood amylase to return to normal, and time for abdominal pain relief in the observation group were lower than those in the control group, and the differences were statistically significant (P<0.05). The incidence of complications, mortality rate, and recurrence rate in the observation group were 2.00%, 2.00%, and 2.00%, respectively, while those in the control group were 14.00%, 14.00%, and 14.00%, respectively. The differences in the various indicators between the two groups were statistically significant.


Therefore, in the treatment of acute biliary pancreatitis patients, ERCP treatmentis safe, effective, and minimally invasive, and can effectively reduce the probability of severe pancreatitis, making it the preferred treatment for acute biliary pancreatitis patients.


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