RÉSUMÉ
Objective:To evaluate the preventive effect of indwelling pancreatic duct guide wire through nasobiliary drainage catheter for post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) in cholelithiasis patients with small-caliber pancreatic duct.Methods:The clinical data of 127 patients with gall bladder and common bile duct stones undergoing ERCP and elective laparoscopic cholecystectomy in the Cholelithiasis Center of Shanghai East Hospital Affiliated to Tongji University from January 2019 to June 2023 were analyzed retrospectively, including 55 males and 72 females, aged (56.95±10.86) years old. According to the preventive methods of PEP, patients were divided into the guide wire group (indwelling pancreatic duct guide wire through nasobiliary drainage catheter), stenting group (nasobiliary catheter with 5Fr 5 cm single pigtail pancreatic duct stent) and conventional group (nasobiliary catheter). The incidence of post-ERCP hyperamylasemia (PEH) and PEP were compared.Results:The incidence of PEH in the guide wire group was lower than that in the conventional group [17.8% (8/45) vs. 43.5% (10/23), P=0.023], and also lower than that in the stenting group [17.8% (8/45) vs. 32.2% (19/59)], despite no statistical significance ( P=0.337). The incidences of PEH were comparable in the stenting group and conventional group [32.2% (19/59) vs. 43.5% (10/23), P=0.096)]. The incidence of PEP in the guide wire group was lower than that in both the stenting group [6.7% (3/45) vs. 23.7% (14/59), P=0.030]. and conventional group [6.7% (3/45) vs. 30.4% (7/23), P=0.025]. The incidences of PEP were comparable in the stenting and conventional group [23.7% (14/59) vs. 30.4% (7/23), P=0.532]. Conclusion:Compared to the preventive pancreatic duct stenting, indwelling pancreatic duct guide wire through nasobiliary drainage catheter can effectively prevent the PEH and PEP in high-risk patients with a small-caliber pancreatic duct.
RÉSUMÉ
Objective Through developing the experimental animal model of ileal transposition (IT) with GK-rats,to explore the effects of ileal transposition on water and food intake,weight change and blood glucose.Methods Thirty male GK-rats were randomly assigned to three groups:IT(n =10),C (n =10) and B (n =10)group.Rats in IT group underwent ileal transposition,and others underwent sham operation.Every group was given sufficient clean water.Water and food intake,weight change blood glucose and oral glucose tolerance test(OGTT) were recorded preoperatively and postoperatively.Results The total deaths of the experiment was four and the general survival rate was 88.6％.After operation,water intake reduced visibly in all groups,IT group was kept low level for a long time but not in C and B group.The food intake of IT group was lower than the other two groups during a certain period,but that phenomenon didnt last long.The weight change showed similarly to the food intake.The fasting plasma glucose(FPG) and OGTT were ameliorated significantly in IT group but not in B and C group.Conclusions It is feasible to develop ileal transposition animal models with GK-rats.Moreover,the author found that the influence of IT on weight in GK rats was transient,but on water intake and blood glucose was lasting.