Clinical Application Of Pancreatic Duct Stent In The Treatment Of Acute Biliary Pancreatitis

Objective: By comparing endoscopic duodenal papillary sphincterotomy(EST),nasal bile drainage(ENBD),pancreatic duct stent drainage(ERPD)and endoscopic duodenal papillary sphincterotomy(EST),Nasal Bile Drainage(ENBD),to explore the role of pancreatic duct stent in the treatment of acute biliary pancreatitis(ABP)in reducing the incidence of complications,clinical improvement and overall outcome Curative effect.Methods:A retrospective analysis of the clinical data of patients(70 cases)with biliary pancreatitis admitted to the People's Hospital of Ningxia Hui Autonomous Region from January 2015 to January 2020,who have been divided into two groups according to different treatment schemes.Research group patients(30 cases): Formal conservative treatment combined with ERCP + EST + ENBD + pancreatic duct stent drainage operation was completed within 72 hours after onset of ABP.Control group patients(40 cases): Formal conservative treatment combined with ERCP + EST + ENBD within 72 hours after onset of ABP.The clinical improvement and overall outcome of the two groups of patients were compared.Results: There was no difference in the gender,age,time from onset to ERCP surgery,leukocytes,hemoglobin,alanine aminotransferase,aspartate aminotransferase,bilirubin,alkaline phosphatase,C-reactive protein,and amylase at the time of admission between the research group and the control group respectively(P>0.05).The pain relief time,hospitalization time,and normal recovery time of amylase in the research group were significantly shorter than those in the control group respectively(P<0.05).The time to restore normal levels of alanine aminotransferase,aspartate aminotransferase,and bilirubin were not different between the two groups(P>0.05).There was 1 death in the research group and 2 deaths in the control group(P> 0.05).The incidence of complications(peripancreatic effusion,pancreatic pseudocyst,pancreatic ascites)in the research group(6.67%)were lower than control group(17.5%),but without statistic significance(P> 0.05).One case(3.33%)in the research group requiring ultrasound or CT guided puncture and drainage was less than the 3 cases(10%)in the control group,but without statistic significance(P> 0.05).Nobody underwent surgicl debridement in research group,one case suffered debiedemental procedure in the control group(P> 0.05).One case was transferred to ICU in the research group less than4 case in the control group,but without statistic significance(P> 0.05).Conclusion:The usage of pancreatic duct stents in patients with ABP is a feasible,safe and effective method,which can improve the process of ABP and improve the overall efficacy.