La pancréatite aiguë après sphinctérotomie endoscopique Revue de 418 cas
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Résumé
Sur base d’un matériel rétrospectif de 418 sphinctérotomies endoscopiques consécutives, les auteurs ont revu l’incidence, l’évolution clinique et les causes possibles de pancréatite aiguë, directement liées au traitement endoscopique.
Après avoir défini les critères diagnostiques de cette complication, ils en déterminent l’incidence globale (2,4%) et l’incidence respective en fonction de la pathologie initiale: 1,8% en cas de maladie lithiasique biliaire et 9% dans les autres indications.
Ces cas ont été également revus en fonction des techniques endoscopiques appliquées. Dans les sphinctérotomies ≪ en un temps ≫, une pancréatite aiguë est survenue dans 0,6 et 5% des cas, selon que l’indication était la lithiase biliaire ou une autre pathologie. Dans les cas de manipulations papillaires difficiles ou multiples, l’incidence est passée à 6 et 16% respectivement.
Ils décrivent enfin les traitements instaurés pour pallier à ce type de complication.
Mots-clés
cholangio wirsungographie endoscopique complications pancréatite aiguë sphincterotomie endoscopiqueAcute pancreatitis after endoscopic papillotomy Review of 418 cases
Summary
From a retrospective material of 418 consecutive endoscopic papillotomies, incidence, clinical course and possible causes of acute pancreatitis following endoscopic treatment are studied.
The overall frequency of 2,4 %, varied from 1,8 % in gallstones diseases up to 9 % in other conditions. In ≪ one step ≫ papillotomies, acute pancreatitis occurs in 0,6 % of gallstones indications and in 5 % of other conditions.
In case of difficult and/or special manipulations (pre-cutting, main pancreatic duct sphincterotomies) the incidence rises respectively to 6 and 16 % for gallstones group and other diseases.
Treatments applied to prevent this complication are described. Prognosis seems to be good and no death was observed in this series.
Key-words
acute pancreatitis complications endoscopic papillotomy endoscopic retrograde cholangio-pancreatographyRéférences
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