Study On The Effect Of FCSERMS In Preventing Post-ERCP Bleeding In Patients With Liver Cirrhosis Complicated With Pancreatic Duct Disease

Objective: The purpose of this study was to investigate the efficacy and safety of FCSERMS in preventing post-ERCP bleeding in patients with liver cirrhosis complicated with pancreatic duct disease through retrospective analysis of 45 cases of patients with liver cirrhosis complicated with pancreatic duct disease in our center.Methods: A retrospective analysis was conducted on the patients who underwent ERCP in the department of Hepatobiliary surgery of our hospital from October 2017 to October 2019 due to liver cirrhosis complicated with pancreatic duct disease.Met inclusion and exclusion criteria of cases can be divided into the liver cirrhosis complicated with pancreatic duct disease with FCSERMS group(group A),with the liver cirrhosis complicated with pancreatic duct disease without FCSERMS group(group B),collection of two groups of gender,age,preoperative coagulation function,disease types,routine blood,postoperative hemoglobin,hematemesis,black,the drainage tube drainage fluid situation,the postoperative complications(postoperative pancreatitis,transient high blood amylase,biliary infection,postoperative jaundice)rates.SPSS Version 18.0 software was used for statistical analysis.Results:1.A total of 45 patients were included in the study,A group(n= 11)and B group(n=34).A group: 5 male patients(45.45%),aged 59± 4.18 years,and 6 female patients(54.55%),aged 64.17±11.44 years.B group: 19 cases(55.88%)were male,59.47±11.76 years old,and 15 cases(44.12%)were female,59.87±7.99 years old.There were 24 male patients and 21 female patients,accounting for 24:21.There was no significant difference in preoperative prothrombin,liver cirrhosis complicated with pancreatic duct disease between the two groups(12.26±1.05 in group A and 12.09±0.98 in group B)(P > 0.05,no statistical significance).There was no significant difference between the two groups of patients with liver cirrhosis complicated with pancreatic duct disease before operation PT :A group 12.26±1.05 and B group 12.09±0.98(P > 0.05,no statistical significance).2.Lower the incidence of postoperative bleeding symptoms the liver cirrhosis complicated with pancreatic duct disease with FCSERMS group: A group(n = 11)in patients with liver cirrhosis complicated with pancreatic duct disease after ERCP: black stool(n = 1),the nasal biliary drainage see bloody fluid(n=1),hemoglobin down > 20g/L(n = 1).B group: hematemesis(n=2),black stool(n=4),bloody fluid in nasobiliary drainage(n=4),blood transfusion ?400ml(n=2),blood transfusion > 400ml(n=1),secondary ERCP hemostasis(n=1),hemoglobin decreased > 20g/L(n=4).post-ERCP bleeding was diagnosed(9.1% A group vs.11.76% B group,P < 0.05,with statistical significance).3.Postoperative hemoglobin decline was lower in the liver cirrhosis complicated with pancreatic duct disease with FCSERMS group: 3 hours after surgery: A group was 4.27±1.85,B group was 8.50±6.171(P < 0.05,with statistical significance)..72 hours after surgery: A group was5.82±4.45 and B group was 10.18±6.53(P < 0.05,with statistical significance).4.Incidence of postoperative complications in the two groups have no obvious difference: A group: postoperative pancreatitis was 0,transient high blood amylase was 9.1%,biliary infection was 9.1%,postoperative jaundice was 0,the total incidence was 18.18%.B group: postoperative pancreatitis was 2.94%,postoperative transient high blood amylase was 8.82%,biliary infection was 2.94%,postoperative jaundice was 2.94%,the total incidence was 17.64%.(c2 test was performed on the data of the two groups,P > 0.05,no statistical significance).Conclusion: FCSERMS implantation has a certain effect on preventing Post-ERCP bleeding in patients with liver cirrhosis complicated with pancreatic duct disease,and FCSERMS implantation does not significantly increase the incidence of other postoperative complications of ERCP in patients with liver cirrhosis complicated with pancreatic duct disease.FCSERMS is a safe and effective method to prevent Post-ERCP bleeding in patients with cirrhosis and cholangiopanpancreatic disease.