Objective:To investigate the value of emergency ERCP in patients with acute biliary-pancreatic diseases.
Methods:Retrospective analysis was made on the clinical data of 51 patients with acute biliary-pancreatic diseases who were treated by emergency ERCP during two years. According to patients′condition, the examination of ERCP plus endoscopic nasobiliary drainage (ENBD) or endoscopic sphincterotomy(EST) was performed. The papilla sphincter was slivered by needle knife in the circumstance of stone impaction in the papilla, or in certain conditions, the calculus was removed by net basket, then, ENBD and endoscopic retrograde biliary stent (ERBS) were undertaken. The therapeutic effect, rate of postoperative complications and mortality rate were observed.
Results:Of the 51 cases, emergency ERCP treatment was successful in 49 cases. The total success rate of endoscopic treatment was 96.1%. Among the 49 cases,7 cases (13.7%) were treated with ERCP and ENBD, 3 cases (5.9%) were treated with ERCP, needle knife sliver of the papilla sphincter and ENBS;29 cases (56.9%) were treated with ERCP, calculus removal and ENBD; 5 cases (9.8%) were treated with ERCP, EST and ENBD; and 5 cases (9.8%) were treated with ERCP and ERBS. Clinical symptoms were obviously relieved within 24 h after ERCP treatment, and with no complications such as enteral perforation, acute severe pancreatitis or hemorrhage. Of the 51 cases, 2 failure cases were treated with open operation; 1 case died of postoperative multiple organ failure(MOF) due to acute obstructive suppurative cholangitis (AOSC).
Conclusions:Emergency ERCP is simple, safe and effective in diagnosis and treatment of acute biliary-pancreatic diseases, which should be the treatment of first choice. ERCP is especially suitable for emergent, critical and severe patients. Emergency ERCP is worthy of widespread clinicaluse.