Læknablaðið - 15.08.1992, Blaðsíða 18

226
LÆKNABLAÐIÐ
endurtekinn. Slíkum blæðingum hefur verið
lýst í allt að 2,5% tilvika eftir HSH (29).
NIÐURLAG
HRGB er tiltölulega ný rannsóknaraðferð hér
á landi, en hefur rutt sér hratt til rúms og
verið skipað sæti meðal þeirra rannsókna sem
helst er beitt við rannsóknir á sjúkdómum í
gallgönguin og briskirtli. Aðgerðir með aðstoð
holsjár hafa einnig sannað gildi sitt og verður
eflaust beitt í auknu mæli í framtíðinni. Af
niðurstöðum þessarar rannsóknar, sem eru í
samræmi við niðurstöður erlendra rannsókna,
er óhætt að draga þær ályktanir að HRGB er
nákvæm og gagnleg rannsókn við greiningu
sjúkdóma í gallgöngum og brispípu. HSH og
brottnám steina úr gallgöngum er oft góður
kostur fyrir sjúklinga. Aukakvillar eru ekki
tíðir, en vægir í flestunr tilfellum, en alvarlegir
aukakvillar konia fyrir. Andlát eins sjúklings
telst óbein afleiðing HRGB og HSH í þessari
rannsókn.
SUMMARY
The importance of diagnostic and therapeutic
ERCP procedures has been clearly proven
over the last several years, in the diagnoses
and treatment of diseases in the biliary tract as
well as in the pancreas. The aim of this study
was to obtain information on indications,
results and complications of ERCP, diagnostic
and therapeutic procedures, performed at the
Reykjavík City Hospital during ten years
period from 1981-1990.
A retrospective analysis was done on 388
patients undergoing 535 diagnostic and
therapeutic endoscopic retrograde cholangio-
pancreatography. In 454 instances (84.9%) the
procedures were successful. Main indications
for the procedures were suspected choledochal
stones in 51.4%, pancreatic disease in 13.6%,
unexplained abdominal pain in 12.2%, and
pancreatic neoplasm in 11.8%. The procedure
was performed due to other indications in
11.0% of the patients.
Endoscopic sphincterotomy was the most
common therapeutic procedure, performed
in 134 cases (88.2%), thereof due to bile duct
stones in 95 cases (70.9%) and stenosis/spasm
in papilla of Vater in 33 cases (24.6%).
The overall complication rate of diagnostic
and therapeutic ERCP was 6.0%.
Complications associated with therapeutic
procedures only were more frequent (9.9%),
compared with diagnostic procedures
(4.4%). The most frequent complication
was pancreatitis in 4.3%, but cholangitis
occured in 11% and bleeding in 0.6%. Severe
necrotizing pancreatitis was the most serious
complication (0.75%). One death (0.3%) was
indirectly related to the ERCP procedure.
The results of this study are in accordance
with other previously reported studies. ERCP
is an accurate and useful examination in the
diagnosis of diseases in the biliary system and
pancreas. ES and endoscopic stone extraction
from the bile ducts is a good therapeutic
option in selected patients. Complications
are not frequent and mild in most cases, but
serious complications do occur.
HEIMILDIR
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