在对大型主要胰腺管道石头进行体外冲击波石术后ERCP的时间
Nasir Saleem1, Feenalie Patel2, James L Watkins2
1Division of Gastroenterology and Hepatology, Indiana University School of Medicine, 550 University Blvd, Suite UH1602, Indianapolis, IN, 46202-5250, USA. nasaleem@iu.edu.
Surgical endoscopy
|October 5, 2023
概括
对于主要胰腺管道的石头,在体外冲击波石术 (ESWL) 后的同一天内逆向胆道血管瘤造影 (ERCP) 是安全有效的. 与延迟ERCP相比,这种方法不会对石头清理结果产生负面影响.
科学领域:
- 胃肠病学 胃肠病学
- 内分泌病学 在内分泌病学.
- 干预性内镜检查是干预性的内镜检查.
背景情况:
- 身体外冲击波石 (ESWL) 碎片大主要胰腺管 (MPD) 石头.
- 内镜逆行胆血管细胞造影 (ERCP) 用于清除ESWL后的碎片.
- 由于潜在的组织胀,ESWL后ERCP的最佳时间尚未确定.
研究的目的:
- 评估同日ERCP在ESWL后对MPD石头的疗效和安全性.
- 为了确定ERCP时间是否影响ESWL治疗后的结果.
主要方法:
- 对218名患者进行ESWL治疗MPD石头的回顾性研究 (2013年1月 - 2019年9月).
- 患者接受了同一天的ERCP或晚期的ERCP (ESWL后1-30天).
- 结果包括石头清除,成功的道化,不良事件和入院率.
主要成果:
- 总体而言,MPD石头清除率为90.4%.
- 在同一天的ERCP (91.7%) 和后来的ERCP (88.2%) 之间,石头清理率相似.
- 管成功,不良事件和入院率在各组之间是可比的.
结论:
- 对于MPD石头,同一天的ERCP遵循ESWL是一个安全有效的程序.
- 延迟ERCP似乎没有改善结果,这表明周围胰腺组织恢复时间不是一个关键因素.
相关概念视频
Endoscopic Procedures V: ERCP
311
Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...
Patient...
311
Urinary Tract Calculi VI: Surgical Management
8
Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
8
Chronic Pancreatitis II: Collaborative Care
99
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
99
Urinary Tract Calculi III: Medical Management
9
The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
9
Acute Pancreatitis II: Clinical Manifestations and Management
134
Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
134


