COMPARATIVE ANALYSIS OF VARIOUS TECHNIQUES FOR PREVENTION OF THE POST-ERCP PANCREATITIS
https://doi.org/10.21292/2078-5658-2015-12-4-31-38
Abstract
Goal: optimization of methods for prevention of acute post-surgery pancreatitis in endoscopic trans-papilliferous operations. Materials and methods. Parallel non-blind randomized trial has been performed. The 1st group included patients (n = 98) who had chest epidural analgesia while performing ERCP, and the 2nd group of patients (n = 97) had narcotic analgesics (intramuscular) and indomethacin (per rectum). Results. It has been found that in the 1st group the acute pancreatitis was statistically significant less diagnosed compared to the patients from the 2nd group (ES 0.22 [CI 95%, 0.06-0.83]). The acute pancreatitis was verified in 3.1% (3/98) of patients in the 1st group, and in 12.4% (12/97) of patients in the second group. When chest epidural analgesia was used for the patients with the high risk of post ERCP pancreatitis, its frequency decreased from 23.3% (10/43) to 4.3% (2/46) of cases. (ES 015 [CI 95%, 0.03-0.75]). Conclusion. The use of chest epidural analgesia is the effective and proved preventive tool for the patients with the high risk of development of post ERCP pancreatitis. Indomethacin (per rectum) can be used for the patients with the low risk of this complication: the chest epidural analgesia is not recommended due to the invasiveness of this technique.
About the Authors
M. I. Turovets
Volgograd State Medical University, Volgograd;
Clinic no. 2, Volgograd State Medical University, Volgograd
Russian Federation
Russian Federation
E. N. Zyubina
Volgograd State Medical University, Volgograd;
Clinic no. 2, Volgograd State Medical University, Volgograd
Russian Federation
Russian Federation
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Review
For citations:
Turovets M.I., Zyubina E.N. COMPARATIVE ANALYSIS OF VARIOUS TECHNIQUES FOR PREVENTION OF THE POST-ERCP PANCREATITIS. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2015;12(4):31-38. (In Russ.) https://doi.org/10.21292/2078-5658-2015-12-4-31-38
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