皮肤透过肝胆囊排水与内镜胆囊支架用于治疗急性胆囊炎,直到腹腔镜胆囊切除术
Kuniya Tanaka1, Yuichi Takano2, Gaku Kigawa1
1Department of General and Gastroenterological Surgery, Showa University Fujigaoka Hospital, Yokohama, Japan.
Asian journal of endoscopic surgery
|October 14, 2023
概括
透皮透肝胆囊排水 (PTGBD) 为急性胆囊炎患者提供了一个比内镜胆囊支架 (EGBS) 更顺的手术途径. EGBS患者的复发率更高,腹腔镜胆囊切除术更复杂.
科学领域:
- 胃肠病学 胃肠病学
- 手术管理的手术管理.
- 肝胆道疾病 肝胆道疾病
背景情况:
- 胆囊排水对于管理中度至重度急性胆囊炎至关重要.
- 皮肤透过肝胆囊排水 (PTGBD) 和内镜胆囊支架 (EGBS) 是关键的管理方法.
研究的目的:
- 为了比较PTGBD与EGBS的临床结果,在经过腹腔镜胆囊切除术 (LC) 治疗急性胆囊炎的患者中,在一个月或更长的排水期后.
主要方法:
- 在1个多月的胆囊排水后进行了LC的43名患者的回顾性比较.
- 患者被分为PTGBD (n=34) 和EGBS (n=9) 组.
- 分析了临床过程,包括胆囊炎复发,LC持续时间,手术期间的因素和术后的结果.
主要成果:
- 在排水期间,PTGBD组的胆囊炎复发率 (9%比44%,p=0.026) 显著降低.
- 腹腔镜胆囊切除术在PTGBD组中不那么复杂,持续时间较短,血液损失较少,排水插入较少.
- EGBS组显示出更多的术后并发症和显著更长的住院时间 (p=0.007) 的趋势.
结论:
- 虽然EGBS在排水等待期间支持日常生活,但PTGBD与较不复杂的腹腔镜胆囊切除术和术后过程有关.
- 在等待手术的精选急性胆囊炎患者中,PTGBD可能是首选的初始排水方法.
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