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Therapeutic effects of PTCD and ERCP in patients with obstructive severe acute biliary pancreatitis

Zhang, X.; Sun, J.; Wu, Y.; Xie, M.; Li, C.; Lv, D.; Yu, W.; Cui, P.

2022-06-23 gastroenterology
10.1101/2022.04.29.22274457 medRxiv
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ObjectiveWe evaluated the therapeutic effects of PTCD and ERCP in patients with obstructive severe acute biliary pancreatitis (SABP). MethodsA total of 62 patients with obstructive SABP were enrolled in this study from July 2013 to July 2019 and divided into three groups: PTCD group (n=22), ERCP group (n=24) and conservative group (n=16). Based on treatment time, PTCD and ERCP groups were further separated into early ([&lt;=] 72 h) and delayed (>72 h) groups. Laboratory indices, hospitalization days, recovery of liver functions and remission of abdominal pain as well as complications were evaluated to establish the efficacy and suitable time. ResultsThe average hospitalization days, time for abdominal pain relief and laboratory indices (leukocyte, blood amylase, ALT and TBiL) recovery were shorter (p<0.05) in PTCD and ERCP groups. The average hospitalization days for the ERCP group (16.71{+/-}3.99) were shorter, compared to the PTCD group (19.64{+/-}4.27) (p<0.05). Complications were few in ERCP (33.33%) and PTCD (27.27%) groups. The average length of stay (13.88{+/-}3.27), recovery time of leukocyte (6.31{+/-}0.92) and TBiL (9.13{+/-}1.98) in the early ERCP group were shorter than in both delayed ERCP and early PTCD groups (p<0.05). The average length of stay (18.63{+/-}4.06) and ALT recovery time (12.25{+/-}2.59) in delayed ERCP group were shorter than in delayed PTCD group (p<0.05). ConclusionsBoth ERCP and PTCD are effective for relieving biliary obstruction during SABP, and early ERCP or PTCD within 72 h for obstructive SABP are more beneficial.

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