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Endoscopy：原发性硬化性胆管炎内镜逆行胰胆管造影并发症发生率相对较低

2012-12-10 刘沛 编译 Endoscopy

原发性硬化性胆管炎内镜逆行胰胆管造影
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　　内镜逆行胰胆管造影（ERCP）对硬化性胆管炎病人是最为准确的检测技术。Ismail医生的研究小组评估了原发性硬化性胆管炎患者内镜逆行胰胆管造影（ERCP）并发症的危险因素。[Endoscopy 2012: DOI: 10.1055/s-0032-1325677] 　　来自芬兰的研究人员于2007至2009年间对原发性硬化性胆管炎病人实施了441例ERCP。ERC

　　内镜逆行胰胆管造影（ERCP）对硬化性胆管炎病人是最为准确的检测技术。Ismail医生的研究小组评估了原发性硬化性胆管炎患者内镜逆行胰胆管造影（ERCP）并发症的危险因素。[Endoscopy 2012: DOI: 10.1055/s-0032-1325677]

　　来自芬兰的研究人员于2007至2009年间对原发性硬化性胆管炎病人实施了441例ERCP。ERCP的基本设备是一根导丝和一把用于切开十二指肠乳头的手术刀，以使导丝进入胆管。如果第一次置管失败并且导丝只进入了胰管，就要将胰管括约肌切开。如果需要，还可以进一步行斜切以暴露胆管。

　　研究小组发现在88%病人中首次置管获得成功，其中有38%的病人之前已行胆管切开。

　　初次置管失败的病人中，有52例在胰管括约肌切开后导管成功置入胆管。这些病人中有11例需要行斜切。

　　研究者发现7%的病人出现ERCP术后胰腺炎（PEP）。PEP的预测因素包括女性和导丝置入胰管。

　　研究小组指出之前实施胆管括约肌切开是一项保护性因素。PEP的风险随着导丝意外穿过胰管的次数的增加而增加。胆管炎的发生率为1%。

　　研究者总结道：“原发性硬化性胆管炎病人ERCP并发症发生率相对较低。并发症风险随着置管的难度的增加而增加。当原发性硬化性胆管炎病人进行ERCP随访时，可以考虑行胆管括约肌切开，因为它可能能够防止PEP的发生。”


Background and study aims
Endoscopic retrograde cholangiographic pancreatography (ERCP) is the most accurate technique for surveillance of patients with primary sclerosing cholangitis (PSC). Our aim was to evaluate risk factors for complications of ERCP in patients with PSC.
Patients and methods
In 2007 - 2009 we performed 441 ERCPs in patients with PSC. The primary tools for ERCP were a guide wire and papillotomy knife to gain access into the biliary duct. If the primary cannulation failed, and the wire went only into the pancreatic duct, pancreatic sphincterotomy was performed. If necessary, a further oblique cut with a needle knife was done in order to expose the biliary duct.
Results
Primary cannulation was successful in 389 patients (88.2 %). Of these, 147 (37.8 %) had had biliary sphincterotomy performed previously. In the group with failed primary cannulation, access into the biliary duct was achieved after pancreatic sphincterotomy in 52 patients. In 11 of these, a further cut with a needle knife was performed. Post-ERCP pancreatitis (PEP) was diagnosed in 31 patients (7.0 %). Factors predicting PEP were female sex (odds ratio [OR] 2.6, P = 0.015) and a guide wire in the pancreatic duct (OR 8.2, P < 0.01). Previous biliary sphincterotomy was a protective factor (OR 0.28, P = 0.02). The risk of PEP increased with the number of times the wire accidentally passed into the pancreatic duct (P < 0.001). Cholangitis developed in 6 patients (1.4 %).
Conclusions
In patients with PSC the incidence of ERCP complications remained relatively low. The complication risk increased with the complexity of cannulation. In a patient with PSC in whom follow-up ERCP is planned, biliary sphincterotomy should be considered, as it may protect against PEP.


    

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    2013-09-26 jiyangfei

    #原发性#

    0

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    2013-11-04 zhaozuguo

    #内镜逆行胰胆管造影#

    0

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    2012-12-27 丁鹏鹏

    #并发#

    0

  4. 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createdBy=2cb730794271, createdName=zhaozuguo, createdTime=Mon Nov 04 17:35:00 CST 2013, time=2013-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1757550, encodeId=f4361e575505d, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Thu Dec 27 06:35:00 CST 2012, time=2012-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1261824, encodeId=0b1912618243c, content=<a href='/topic/show?id=0ceb30545e0' target=_blank style='color:#2F92EE;'>#内镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, 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createdBy=c21721182790, createdName=cmj15wellington, createdTime=Wed Dec 12 08:35:00 CST 2012, time=2012-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1826213, encodeId=2eab18262136c, content=<a href='/topic/show?id=e5283e89970' target=_blank style='color:#2F92EE;'>#发生率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37899, encryptionId=e5283e89970, topicName=发生率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Mon Feb 11 04:35:00 CST 2013, time=2013-02-11, status=1, ipAttribution=)]
    2012-12-12 jiafufeng@yaho

    #内镜#

    0

  5. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94973, encryptionId=3e34949e333, topicName=造影)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=908d9134595, createdName=sodoo, createdTime=Wed Dec 12 08:35:00 CST 2012, time=2012-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1495874, encodeId=916714958e46f, content=<a href='/topic/show?id=3f696e7069' target=_blank style='color:#2F92EE;'>#endoscopy#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6770, encryptionId=3f696e7069, topicName=endoscopy)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f4a39226300, createdName=liuxiaona, createdTime=Wed Dec 12 08:35:00 CST 2012, time=2012-12-12, status=1, ipAttribution=), 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createdBy=c21721182790, createdName=cmj15wellington, createdTime=Wed Dec 12 08:35:00 CST 2012, time=2012-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1826213, encodeId=2eab18262136c, content=<a href='/topic/show?id=e5283e89970' target=_blank style='color:#2F92EE;'>#发生率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37899, encryptionId=e5283e89970, topicName=发生率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Mon Feb 11 04:35:00 CST 2013, time=2013-02-11, status=1, ipAttribution=)]
    2012-12-12 weihongyv

    #原发性硬化性胆管炎#

    0

  6. 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GetPortalCommentsPageByObjectIdResponse(id=1496264, encodeId=c2711496264d8, content=<a href='/topic/show?id=43b6e358710' target=_blank style='color:#2F92EE;'>#硬化性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73587, encryptionId=43b6e358710, topicName=硬化性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d8119265602, createdName=Smile2683, createdTime=Wed Dec 12 08:35:00 CST 2012, time=2012-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1628234, encodeId=35301628234a3, content=<a href='/topic/show?id=9a4e83503e4' target=_blank style='color:#2F92EE;'>#胆管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83503, encryptionId=9a4e83503e4, topicName=胆管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c21721182790, createdName=cmj15wellington, createdTime=Wed Dec 12 08:35:00 CST 2012, time=2012-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1826213, encodeId=2eab18262136c, content=<a href='/topic/show?id=e5283e89970' target=_blank style='color:#2F92EE;'>#发生率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37899, encryptionId=e5283e89970, topicName=发生率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Mon Feb 11 04:35:00 CST 2013, time=2013-02-11, status=1, ipAttribution=)]
    2012-12-12 sodoo

    #造影#

    0

  7. 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topicList=[TopicDto(id=30545, encryptionId=0ceb30545e0, topicName=内镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Wed Dec 12 08:35:00 CST 2012, time=2012-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1423895, encodeId=d23f14238955d, content=<a href='/topic/show?id=219d3e07851' target=_blank style='color:#2F92EE;'>#原发性硬化性胆管炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37078, encryptionId=219d3e07851, topicName=原发性硬化性胆管炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c7c83872517, createdName=weihongyv, createdTime=Wed Dec 12 08:35:00 CST 2012, time=2012-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1493955, encodeId=ac63149395571, content=<a href='/topic/show?id=3e34949e333' target=_blank style='color:#2F92EE;'>#造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94973, encryptionId=3e34949e333, topicName=造影)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=908d9134595, createdName=sodoo, createdTime=Wed Dec 12 08:35:00 CST 2012, time=2012-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1495874, encodeId=916714958e46f, content=<a href='/topic/show?id=3f696e7069' target=_blank style='color:#2F92EE;'>#endoscopy#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6770, encryptionId=3f696e7069, topicName=endoscopy)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f4a39226300, createdName=liuxiaona, createdTime=Wed Dec 12 08:35:00 CST 2012, time=2012-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1496264, encodeId=c2711496264d8, content=<a href='/topic/show?id=43b6e358710' target=_blank style='color:#2F92EE;'>#硬化性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73587, encryptionId=43b6e358710, topicName=硬化性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d8119265602, createdName=Smile2683, createdTime=Wed Dec 12 08:35:00 CST 2012, time=2012-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1628234, encodeId=35301628234a3, content=<a href='/topic/show?id=9a4e83503e4' target=_blank style='color:#2F92EE;'>#胆管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83503, encryptionId=9a4e83503e4, topicName=胆管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c21721182790, createdName=cmj15wellington, createdTime=Wed Dec 12 08:35:00 CST 2012, time=2012-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1826213, encodeId=2eab18262136c, content=<a href='/topic/show?id=e5283e89970' target=_blank style='color:#2F92EE;'>#发生率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37899, encryptionId=e5283e89970, topicName=发生率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Mon Feb 11 04:35:00 CST 2013, time=2013-02-11, status=1, ipAttribution=)]
    2012-12-12 liuxiaona

    #endoscopy#

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1846438, encodeId=a46618464384f, content=<a href='/topic/show?id=d3a33e0306d' target=_blank style='color:#2F92EE;'>#原发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37030, encryptionId=d3a33e0306d, topicName=原发性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8e4c53, createdName=jiyangfei, createdTime=Thu Sep 26 20:35:00 CST 2013, time=2013-09-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1704621, encodeId=bdd91e04621de, content=<a href='/topic/show?id=5f0f3059420' target=_blank style='color:#2F92EE;'>#内镜逆行胰胆管造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30594, encryptionId=5f0f3059420, topicName=内镜逆行胰胆管造影)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2cb730794271, createdName=zhaozuguo, createdTime=Mon Nov 04 17:35:00 CST 2013, time=2013-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1757550, encodeId=f4361e575505d, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Thu Dec 27 06:35:00 CST 2012, time=2012-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1261824, encodeId=0b1912618243c, content=<a href='/topic/show?id=0ceb30545e0' target=_blank style='color:#2F92EE;'>#内镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30545, encryptionId=0ceb30545e0, topicName=内镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Wed Dec 12 08:35:00 CST 2012, time=2012-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1423895, encodeId=d23f14238955d, content=<a href='/topic/show?id=219d3e07851' target=_blank style='color:#2F92EE;'>#原发性硬化性胆管炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37078, encryptionId=219d3e07851, topicName=原发性硬化性胆管炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c7c83872517, createdName=weihongyv, createdTime=Wed Dec 12 08:35:00 CST 2012, time=2012-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1493955, encodeId=ac63149395571, content=<a href='/topic/show?id=3e34949e333' target=_blank style='color:#2F92EE;'>#造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94973, encryptionId=3e34949e333, topicName=造影)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=908d9134595, createdName=sodoo, createdTime=Wed Dec 12 08:35:00 CST 2012, time=2012-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1495874, encodeId=916714958e46f, content=<a href='/topic/show?id=3f696e7069' target=_blank style='color:#2F92EE;'>#endoscopy#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6770, encryptionId=3f696e7069, topicName=endoscopy)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f4a39226300, createdName=liuxiaona, createdTime=Wed Dec 12 08:35:00 CST 2012, time=2012-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1496264, encodeId=c2711496264d8, content=<a href='/topic/show?id=43b6e358710' target=_blank style='color:#2F92EE;'>#硬化性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73587, encryptionId=43b6e358710, topicName=硬化性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d8119265602, createdName=Smile2683, createdTime=Wed Dec 12 08:35:00 CST 2012, time=2012-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1628234, encodeId=35301628234a3, content=<a href='/topic/show?id=9a4e83503e4' target=_blank style='color:#2F92EE;'>#胆管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83503, encryptionId=9a4e83503e4, topicName=胆管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c21721182790, createdName=cmj15wellington, createdTime=Wed Dec 12 08:35:00 CST 2012, time=2012-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1826213, encodeId=2eab18262136c, content=<a href='/topic/show?id=e5283e89970' target=_blank style='color:#2F92EE;'>#发生率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37899, encryptionId=e5283e89970, topicName=发生率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Mon Feb 11 04:35:00 CST 2013, time=2013-02-11, status=1, ipAttribution=)]
    2012-12-12 Smile2683

    #硬化性#

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1846438, encodeId=a46618464384f, content=<a href='/topic/show?id=d3a33e0306d' target=_blank style='color:#2F92EE;'>#原发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37030, encryptionId=d3a33e0306d, topicName=原发性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8e4c53, createdName=jiyangfei, createdTime=Thu Sep 26 20:35:00 CST 2013, time=2013-09-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1704621, encodeId=bdd91e04621de, content=<a href='/topic/show?id=5f0f3059420' target=_blank style='color:#2F92EE;'>#内镜逆行胰胆管造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30594, encryptionId=5f0f3059420, topicName=内镜逆行胰胆管造影)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2cb730794271, createdName=zhaozuguo, createdTime=Mon Nov 04 17:35:00 CST 2013, time=2013-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1757550, encodeId=f4361e575505d, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Thu Dec 27 06:35:00 CST 2012, time=2012-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1261824, encodeId=0b1912618243c, content=<a href='/topic/show?id=0ceb30545e0' target=_blank style='color:#2F92EE;'>#内镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30545, encryptionId=0ceb30545e0, topicName=内镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Wed Dec 12 08:35:00 CST 2012, time=2012-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1423895, encodeId=d23f14238955d, content=<a href='/topic/show?id=219d3e07851' target=_blank style='color:#2F92EE;'>#原发性硬化性胆管炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37078, encryptionId=219d3e07851, topicName=原发性硬化性胆管炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c7c83872517, createdName=weihongyv, createdTime=Wed Dec 12 08:35:00 CST 2012, time=2012-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1493955, encodeId=ac63149395571, content=<a href='/topic/show?id=3e34949e333' target=_blank style='color:#2F92EE;'>#造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94973, encryptionId=3e34949e333, topicName=造影)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=908d9134595, createdName=sodoo, createdTime=Wed Dec 12 08:35:00 CST 2012, time=2012-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1495874, encodeId=916714958e46f, content=<a href='/topic/show?id=3f696e7069' target=_blank style='color:#2F92EE;'>#endoscopy#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6770, encryptionId=3f696e7069, topicName=endoscopy)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f4a39226300, createdName=liuxiaona, createdTime=Wed Dec 12 08:35:00 CST 2012, time=2012-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1496264, encodeId=c2711496264d8, content=<a href='/topic/show?id=43b6e358710' target=_blank style='color:#2F92EE;'>#硬化性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73587, encryptionId=43b6e358710, topicName=硬化性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d8119265602, createdName=Smile2683, createdTime=Wed Dec 12 08:35:00 CST 2012, time=2012-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1628234, encodeId=35301628234a3, content=<a href='/topic/show?id=9a4e83503e4' target=_blank style='color:#2F92EE;'>#胆管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83503, encryptionId=9a4e83503e4, topicName=胆管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c21721182790, createdName=cmj15wellington, createdTime=Wed Dec 12 08:35:00 CST 2012, time=2012-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1826213, encodeId=2eab18262136c, content=<a href='/topic/show?id=e5283e89970' target=_blank style='color:#2F92EE;'>#发生率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37899, encryptionId=e5283e89970, topicName=发生率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Mon Feb 11 04:35:00 CST 2013, time=2013-02-11, status=1, ipAttribution=)]
    2012-12-12 cmj15wellington

    #胆管#

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=1846438, encodeId=a46618464384f, content=<a href='/topic/show?id=d3a33e0306d' target=_blank style='color:#2F92EE;'>#原发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37030, encryptionId=d3a33e0306d, topicName=原发性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8e4c53, createdName=jiyangfei, createdTime=Thu Sep 26 20:35:00 CST 2013, time=2013-09-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1704621, encodeId=bdd91e04621de, content=<a href='/topic/show?id=5f0f3059420' target=_blank style='color:#2F92EE;'>#内镜逆行胰胆管造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30594, encryptionId=5f0f3059420, topicName=内镜逆行胰胆管造影)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2cb730794271, createdName=zhaozuguo, createdTime=Mon Nov 04 17:35:00 CST 2013, time=2013-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1757550, encodeId=f4361e575505d, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Thu Dec 27 06:35:00 CST 2012, time=2012-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1261824, encodeId=0b1912618243c, content=<a href='/topic/show?id=0ceb30545e0' target=_blank style='color:#2F92EE;'>#内镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30545, encryptionId=0ceb30545e0, topicName=内镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Wed Dec 12 08:35:00 CST 2012, time=2012-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1423895, encodeId=d23f14238955d, content=<a href='/topic/show?id=219d3e07851' target=_blank style='color:#2F92EE;'>#原发性硬化性胆管炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37078, encryptionId=219d3e07851, topicName=原发性硬化性胆管炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c7c83872517, createdName=weihongyv, createdTime=Wed Dec 12 08:35:00 CST 2012, time=2012-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1493955, encodeId=ac63149395571, content=<a href='/topic/show?id=3e34949e333' target=_blank style='color:#2F92EE;'>#造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94973, encryptionId=3e34949e333, topicName=造影)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=908d9134595, createdName=sodoo, createdTime=Wed Dec 12 08:35:00 CST 2012, time=2012-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1495874, encodeId=916714958e46f, content=<a href='/topic/show?id=3f696e7069' target=_blank style='color:#2F92EE;'>#endoscopy#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6770, encryptionId=3f696e7069, topicName=endoscopy)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f4a39226300, createdName=liuxiaona, createdTime=Wed Dec 12 08:35:00 CST 2012, time=2012-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1496264, encodeId=c2711496264d8, content=<a href='/topic/show?id=43b6e358710' target=_blank style='color:#2F92EE;'>#硬化性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73587, encryptionId=43b6e358710, topicName=硬化性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d8119265602, createdName=Smile2683, createdTime=Wed Dec 12 08:35:00 CST 2012, time=2012-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1628234, encodeId=35301628234a3, content=<a href='/topic/show?id=9a4e83503e4' target=_blank style='color:#2F92EE;'>#胆管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83503, encryptionId=9a4e83503e4, topicName=胆管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c21721182790, createdName=cmj15wellington, createdTime=Wed Dec 12 08:35:00 CST 2012, time=2012-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1826213, encodeId=2eab18262136c, content=<a href='/topic/show?id=e5283e89970' target=_blank style='color:#2F92EE;'>#发生率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37899, encryptionId=e5283e89970, topicName=发生率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Mon Feb 11 04:35:00 CST 2013, time=2013-02-11, status=1, ipAttribution=)]
    2013-02-11 一叶知秋

    #发生率#

    0

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