Acute Pancreatitis
Conditions
Interventions
ERPD Group :Patients who successfully received pancreatic duct stent placement after undergoing emergency ERCP within 48 hours, following routine pre-procedure rectal indomethacin suppositories and ES
Non-ERPD Group :High-risk patients who underwent emergency ERCP within 48 hours of onset, routinely received pre-operative rectal indomethacin, underwent EST combined with ENBD/ERBD, and did not under
Sponsors
Shanghai General Hospital
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. Age >=18 years old; 2. Meeting the diagnostic criteria for AP: According to the international consensus on the revision of the Atlanta Classification and Definitions in 2012, the diagnosis of AP requires two of the following three characteristics: Abdominal pain conforms to the features of acute pancreatitis (acute onset, persistent, severe upper abdominal pain often radiating to the back); The activity of serum lipase (or amylase) should be at least three times greater than the upper limit of normal. The characteristic changes of acute pancreatitis are detected by abdominal CT or less commonly used magnetic resonance imaging (MRI) or abdominal ultrasound. 3. Meet the diagnostic criteria for acute biliary pancreatitis: Imaging findings suggest the presence of bile sludge or gallstones, and common bile duct dilation (common bile duct diameter > 8mm in patients 10mm in patients over 75 years old). Or the concentration of alanine aminotransferase (ALT) is greater than twice the upper limit of normal; 4. Meet the diagnostic criteria for cholangitis: fever combined with common bile duct stones, common bile duct dilation or progressive cholestasis. Cholestasis is defined as serum bilirubin exceeding 2.3 mg/dL (40 µmol/L). 5. Within 48 hours of onset, emergency ERCP (EST+ENBD/ERBD) was performed and difficult intubation occurred during the operation: meeting the "5-5-2" criteria, that is, more than 5 attempts of intubation through the nipple, more than 5 minutes of intubation attempts under direct vision, and 2 or more accidental pancreatic intubation or imaging. 6. All patients who meet the inclusion and exclusion criteria must obtain their informed consent.
Exclusion criteria
Exclusion criteria: 1.Upon admission, the patient was diagnosed with necrotizing pancreatitis or infectious pancreatic necrosis. 2. Patients with severe multiple organ failure, coma, severe dementia or mental illness who cannot tolerate the operation; 3. Previous pancreatic cancer or other malignant tumors; 4. AP caused by other reasons; 5. Concurrent pregnancy; 6. Previous chronic renal insufficiency, heart failure and respiratory failure; 7. After gastrointestinal diversion surgery; 8. Postoperative pancreatic surgery; 9. During this hospitalization, percutaneous transhepatic biliary drainage (PTCD), cholecystostomy and cholecystectomy were performed.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The incidence rate of MSAP/SAP; | — |
Secondary
| Measure | Time frame |
|---|---|
| The incidence rate of APFC;The incidence rate of ARDS; | — |
Countries
China
Contacts
Public ContactXiao Han
Shanghai General Hospital
Outcome results
None listed