关键词: 单纯表面麻醉, 静脉全身麻醉, 经内镜逆行胰胆管造影术, 高淀粉酶血症, ERCP术后胰腺炎

Abstract: Objective To investigate the effects of simple topical anesthesia and intravenous general anesthesia on the occurrence of pancreatitis after ERCP.Methods 400 Patients who underwent ERCP due to pancreaticobiliary duct disease in our hospital from January 2021 to March 2023 were selected and divided into two groups:Simple topical anesthesia group and intravenous general anesthesia group,200 cases in each group.The levels of venous pancreatic amylase and abdominal symptoms and signs were recorded in the two groups before operation and 3h and 24h after operation.The observation results were hyperamylaseemia and postoperative pancreatitis at 3h and 24h after operation.Results The incidence of postoperative pancreatitis after ERCP was higher in the superficial anesthesia group than in the intravenous general anesthesia group (7.5% and 2.0%,respectively;P<0.05),there was statistical significance;The level of serum pancreatic amylase (198±216)U/L in intravenous general anesthesia group was significantly lower than that in superficial anesthesia group (379±327)U/L at 3h after surgery (P<0.05).The level of serum pancreatic amylase (129±98)U/L in intravenous general anesthesia group was lower than that in superficial anesthesia group (187±156) at 24h after surgery (P<0.05).The incidence of hyperamylasemia was 15.5% (31/200 cases) in the 3h postoperative intravenous general anesthesia group,lower than that in the simple surface anesthesia group (34.5%）(69/200 cases),and 5.5%(11/200 cases) in the 24h postoperative intravenous general anesthesia group,lower than that in the simple surface anesthesia group (19.0%) (38/200 cases)(P<0.05).Conclusion Compared with simple surface anesthesia,intravenous general anesthesia can reduce the level of serum amylase after ERCP,and can reduce the occurrence of pancreatitis after ERCP.

Key words: simple superficial anesthesia, intravenous general anaesthesia, endoscopic retrograde cholangiopancreatography, hyperamylasemia, post-endoscopic retrograde cholangiopancreatography pancreatitis