在内镜清除后常见胆道结石的复发及其预测因素:系统性审查
Marko Kozyk1, Suprabhat Giri2, Sidharth Harindranath3
1Department of Internal Medicine Corewell Health William Beaumont University Hospital Royal Oak Michigan USA.
DEN open
|October 11, 2023
概括
胆道结石的复发影响了内镜逆行胆道细胞造影术后约12.6%的患者. 胆管直径和解剖学是关键预测因素,指导高风险个体的随访.
科学领域:
- 胃肠病学 胃肠病学
- 肝病学 肝病学是一种肝病学.
- 内視鏡外科手術 內視鏡外科手術
背景情况:
- 内镜逆行胆血管细胞造影 (ERCP) 是胆道结石 (BDS) 的主要治疗方法.
- 在ERCP后BDS复发是一个公认的临床挑战.
- 确定BDS复发的预测因素对于患者管理至关重要.
研究的目的:
- 为了确定ERCP后症状性BDS复发的发生率.
- 系统地审查和分析与BDS复发相关的风险因素.
- 确定BDS复发的最重要的风险因素.
主要方法:
- 在三个数据库中进行了系统的文献搜索,截至2022年11月.
- 包括在ERCP清除和风险因素分析后报告BDS复发的研究.
- 对37项涉及12,952名患者的研究数据进行了元分析.
主要成果:
- 在ERCP后BDS的综合复发率为12.6%.
- 胆道直径≥15毫米是十二项研究中发现的最重要的危险因素.
- 其他显著的危险因素包括胆道角缩小,腹膜周转,胆囊结石,胆囊切除术,多块结石和支架放置.
结论:
- 大约七分之一的患者在ERCP后经历了BDS复发.
- 胆管的大小和解剖学变异是复发的主要预测因素.
- 风险因素评估有助于针对性跟踪对复发风险较高的患者进行针对性跟踪.
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