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Læknablaðið - 15.02.1997, Side 43

Læknablaðið - 15.02.1997, Side 43
LÆKNABLAÐIÐ 1997; 83 115 1,5% allra hringvöðvaskurða en lýst er 2,9% tíðni (15). Afdrifaríkasti aukakvillinn í þessu uppgjöri var bráð brisbólga og létust þrír sjúklingar af þeim sex er fengu hana. Tveir sjúklingar létust eftir aðgerðir en einn eftir rannsókn þar sem engin aðgerð var framkvæmd. Dánartíðni án aðgerðar er um 0,2% (16) og eftir hringvöðva- skurð 0,8-3,6% (18,19). Niðurstaða þessarar rannsóknar er ásættanleg, 0,5% heildardánar- tíðni, 0,4% eftir greiningarrannsókn og 0,8% eftir hringvöðvaskurð. Þessar niðurstöður sýna að holsjárröntgenmyndun af gallvegum og brisgangi er rannsókn sem hefur í för með sér áhættu á aukaverkunum, einkum bris- bólgu. Fylgikvillum fækkar með bættri tækni og reynslu þeirra sem framkvæma rannsókn- irnar þó vafasamt sé að algjörlega takist að koma í veg fyrir aukakvilla. Þakkir Vísindasjóður styrkti rannsóknina. HEIMILDIR 1. McCune WS, Shorb PE, Moscovitz H. Endoscopic can- nulation of the ampulla of Vater: a preliminary report. Ann Surg 1968; 167: 752-6. 2. Kawai K, Akasaka Y. Murakami K, Tada M, Kohii Y, Nakajima M. Endoscopic sphincterotomy of the ampul- la of Vater, Gastrointest Endosc 1974; 20: 148-51. 3. Witzel L, Hacki W, Halter F, Simple method for remov- al of gallstones after duodenoscopic sphincterotomy. N Engl J Med 1977; 296: 1536-7. 4. Theodórs Á, Hrafnkelsson H. Holsjárröntgenmyndun af gallgöngum og brispípu. Rannsóknir og aðgerðir framkvæmdar á Borgarspítalanum 1981-1990. Lækna- biaðið 1992; 78: 221-7. 5. Gilinsky NH, Bornman PC, Girdwood AH, Marks IN. Diagnostic yield of endoscopic retrograde cholangio- pancreatography in carcinoma of the pancreas. Br J Surg 1986; 73: 539-43. 6. Nix GAJJ, Schmitz PIM, Wilson JHP. Carcinoma of the head of pancreas. Therapeutic implications of endoscop- ic retrograde cholangiopancreatography findings. Gas- troenterology 1984; 87 : 37-43. 7. Kullman E, Borch K, Tarpila E, Liedberg G. Endoscop- ic retrograd cholangiopancreatography (ERCP) in pa- tients with jaundice and suspected biliary obstruction. Acta Chir Scand 1984; 150: 657-63. 8. Ruddei WSJ, Lintott DJ, Axon ATR. The diagnostic yield of ERCP in investigation of unexplained abdom- inal pain. Br J Surg 1983; 70: 74-5. 9. Health and public policy committee, American college of physicians; Philadelphia Pennsylvania. Clinical com- petence in diagnostic endoscopic retrograde cholangio- pancreatography. Ann Int Med 1988; 108: 142—4. 10. Van Der Spuy S. Endoscopic retrograde cholangiopan- creatography and endoscopic sphincterotomy in the management of suspected gallstone pancreatitis. S Afr Med J 1991; 79: 16-8. 11. Steward ET, Vennes JA, Geenen JE. Atlas of endo- scopic retrograde cholangiopancreatography. St. Louis: CV Mosby, 1977. 12. Hall RI, Ingoldby CJH, Denyer ME. Periampullary di- verticula predispose to primary rather than secondary stones in the common bile duct. Endoscopy 1990; 22: 127-8. 13. Tulassay Z. Endoscopic Retrograde Cholangiopancrea- tography in Mirizzi syndrome. Am J Gastroenterol 1987; 82: 391. 14. Agha FP. Williams KD. Pancreas divisum: incidence, detection, and clinical significance. Am J Gastroenterol 1987; 82; 315-20 15. Cotton PB, Vallon AG. British experience with duode- noscopic sphincterotomy for removal of bile duct stones. Br J Surg 1981; 68: 373-5. 16. Slivka A, Carr-Locke DL. Therapeutic biliary endosco- py. Endoscopy 1992; 24: 100-19. 17. Scheeres DE, Simon I, Ponsky JL. Endoscopic retro- grade cholangiopancreatography in general surgery practice. Am Surg 1990; 56: 185—91. 18. Bilbao MK, Dotter CT, Lee TG, Katon RM. Complica- tions of endoscopic retrograde cholangiopancreatogra- phy (ERCP). Gastroenterology 1976; 70: 314-20. 19. Lenriot JP, Le-Neel JC, Hay JM, Jaeck D, Millat B, Fagniez PL. Retrograde cholangiopancreatography and endoscopic sphincterotomy for biliary lithiasis. Gas- troenterol Clin Biol 1993; 17: 244-50. 20. Viceconte G, Viceconte GW, Pietropaolo V, Montori A. Endoscopic sphincterotomy: indications and results. Br J Surg 1981; 68: 376-80. 21. Soergel KH. Acute pancreatitis. In: Sleisenger and Fordtran. Gastrointestinal disease. 5th ed. Vol. 2. Phila- delphia: W.B. Saunders Company, 1993: 1629-53. 22. Cotton PB. Towards safer endoscopic retrograde cho- langiopancreatography (ERCP). Gut 1994; 35: 284. 23. Stanten R, Frey CF. Pancreatitis after endoscopic retro- grade cholangiopancreatography. An underreported disease whose severity is often unappreciated. Arch Surg 1990; 125: 1032-4. 24. Kasugai T, KunoN, Kobayashi S, Hattori K. Endoscop- ic pancreatocholangiography. Gastroenterology 1972; 63: 217-26. 25. Yoshimoto S, Ohnishi R, Doi S, Kawai K. Endoscopic retrograde pancreatic parenchymograhpy. Radiology 1981; 141: 219-22. 26. Lifton L, Brooks C, Rosson R, Scheig R. The effect of upper gastrointestinal endoscopy on serum amylase (abs). Gastroenterology 1975; 68: 936. 27. Novello P, Hagege H, Ducreux M, Buffet C, Choury A, Fritsch J, et al. Septicemias after endoscopic retrograde cholangiopancreatography. Gastroenterol Clin Biol 1993; 17: 897-902.

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