关键词: 内镜下十二指肠乳头切除术, 术后胰腺炎, 术后出血, 不良事件, 十二指肠乳头肿瘤

Abstract: Objective  To explore the risk factors related to short-term adverse events after endoscopic papillectomy (EP). Methods  Patients with duodenal papilla neoplasms (DPNs) undergoing EP were included in this study, and their general information, laboratory examination indicators, operation related conditions and pathological conditions were collected. The above indicators were preliminarily statistically analyzed by independent sample t test, Mann Whitney U test and chi square test, and the clinical factors related to postoperative adverse events were screened. Results  Among 78 patients with DPNs who received EP, 43 patients had the above four adverse events, including 14 cases (17.9%) of postoperative acute pancreatis (AP), 7 cases (9.0%) of postoperative bleeding, 14 cases (17.9%) of hyperamylasemia, and 10 cases (12.8%) of nonspecific abdominal pain. The history of diabetes and height of patients may be the related factors of postoperative adverse events. The elevation of preoperative ALT level and immediate postoperative inflammatory indicators is helpful to early identify the occurrence of postoperative AP and bleeding. Endoscopic mucosal resection (EMR) is helpful to reduce the incidence of postoperative AP, while en bloc resection of the lesion is conducive to the prevention of postoperative bleeding. The size of the lesion and the degree of malignancy also affect the occurrence of postoperative adverse events. Conclusion  Prophylactic stent placement and submucosal injection during EP can not improve the postoperative situation, while indicators such as endoscopic resection method and en bloc resection have an impact on the occurrence of adverse events after EP.

Key words: endoscopic papillectomy, postoperative acute pancreatis, postoperative bleeding, adverse events, duodenal papilla neoplasms