胆囊切除术是在同一入院期间内镜清除常见胆道后的胆囊切除术
Eric Bergeron1, Théo Doyon2, Thibaut Manière2
1Department of Surgery, Hôpital Charles LeMoyne, Greenfield Park, Que. (Bergeron); Department of Gastroenterology, Hôpital Charles LeMoyne, Greenfield Park, Que. (Doyon, Maniere, Desilets) eric.bergeron.med@ssss.gouv.qc.ca.
Canadian journal of surgery. Journal canadien de chirurgie
|September 21, 2023
概括
在通过ERCP清除普通胆道结石后在同一住院期间进行胆囊切除术是安全的. 这种方法可以预防复发的胆汁事件,特别是与延迟手术相比,患有并发症的老年患者.
科学领域:
- 胃肠病学 胃肠病学
- 肝胆道手术 肝胆道手术
- 临床结果研究研究
背景情况:
- 在ERCP后,常见的胆道结石和胆道事件的复发是常见的.
- 建议进行早期胆囊切除术,但在同一住院期间不一致地进行.
研究的目的:
- 为了比较ERCP后早期与延迟胆囊切除术的安全性和有效性,用于常见的胆道结石清除.
- 评估对复发性胆汁事件和患者结局的影响.
主要方法:
- 对268名接受ERCP治疗胆结石疾病和随后胆囊切除术的患者的回顾性审查 (2012年7月至2022年6月).
- 患者被分为同一入院 (指数) 和延迟胆囊切除组.
- 对人口统计,并发症 (ASA分数),手术结果和复发率的分析.
主要成果:
- 71名患者 (26.6%) 接受了同一时间的胆囊切除术. 老年患者 (≥80岁) 和具有较高ASA分数的患者在指数组中更频繁.
- 两组之间手术并发症,开放胆囊切除术或死亡率没有显著差异.
- 晚期胆囊切除术与更长的手术时间和手术前复发的常见胆道结石 (18.3%) 和胆结石事件 (38.6%) 的显著率有关. 在指数组中没有观察到复发.
结论:
- 在ERCP后的同剂量胆囊切除术是安全的和可行的,即使是患有并发症的老年患者.
- 与延迟手术相比,早期胆囊切除术有效地预防了反复发生的胆汁事件.
- 这一策略提供了一种安全且可能更有效的方法来管理ERCP后的常见胆道结石.
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