探讨不同操作难度的内镜逆行性胰胆管造影术（ERCP）与ERCP术成功率、操作时间和并发症的差别。

回顾性分析2009年1月至2018年12月于新疆维吾尔自治区人民医院消化科行ERCP术1047例患者的病例资料。根据ERCP操作难度分级将其分为4个不同等级并比较不同操作难度ERCP的插管成功率、操作时间和并发症发生率的差别。

根据ERCP操作难度分级，将1047例病例分成四级，其中1级患者42例，2级813例，3级188例，4级4例；1~3级病例插管成功率均在95%及以上，差别无统计学意义，而4级插管成功率仅为50%，与其他3级比较的差异有统计学意义（P＜0.05）；操作时间从1级到4级逐渐增加，各级比较的差异有统计学意义（P＜0.05）；术后并发症发生率随着难度程度的增加而增加，1~3级之间差异有统计学意义（P＜0.05），3级与4级之间差异无统计学意义。

随着ERCP操作难度级别的上升，插管成功率下降，操作时间增加，且并发症的发生率上升，故手术操作实行医师分级对降低操作风险和并发症发生率有重要意义。

To explore the differences between the different difficulty of endoscopic retrograde cholangiopancreatography (ERCP) ERCP operation and the success rate,operation time, and complications of ERCP;

A retrospective analysis was made of 1047 patients who underwent ERCP in the Department of Gastroenterology, Xinjiang Uygur Autonomous Region People's Hospital from January 2009 to December 2018. According to the difficulty classification of ERCP, the patients were divided into four grades. The success rate of ERCP intubation, operation time, and incidence of complications was compared between them;

According to the difficulty classification of ERCP operation, 1047 cases were divided into four grades, including 42 cases of grade 1, 813 cases of grade 2, 188 cases of grade 3 and 4 cases of grade 4. The success rate of intubation in Grade 1-3 cases was 95% or more, with no statistical significance, while the success rate of grade 4 intubation was only 50%. There was a significant difference between grades 1, 2, and 3 (P＜0.05). The operation time gradually increased from level 1 to 4, and there was a significant difference between different levels (P＜0.05). The incidence of complications increased with the degree of difficulty. There was a considerabl difference between grade 1 and grade 3 (P＜0.05), and there was no significant difference between grade 3 and grade 4;

As the level of ERCP operation rises, the success rate of intubation decreases, the operation time increases, and the incidence of complications increases. Therefore, it is essential to carry out the graded operation by physicians to reduce the risk of process and complications.