急性胆道炎:恶性胆道阻塞与胆道胆病病因学是否会改变临床表现和结果?
Yung-Kuan Tsou1, Yi-Tse Su1, Cheng-Hui Lin1
1Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan.
World journal of clinical cases
|November 10, 2023
概括
恶性胆道阻塞 (MBO) 导致急性胆道炎的结果比普通胆道结石 (CBDS) 更糟糕. 在MBO患者中,早期ERCP对于更好的预后和降低死亡率至关重要.
科学领域:
- 胃肠病学 胃肠病学
- 肝病学 肝病学是一种肝病学.
- 手术瘤学手术瘤学
背景情况:
- 急性胆道炎 (AC) 的临床结果可能因病因而异.
- 调查与恶性胆道阻塞 (MBO) 与常见胆道结石 (CBDS) 相关的AC结果是重要的.
研究的目的:
- 为了比较由MBO和CBDS引起的AC的临床结果.
- 确定影响AC患者预后的因素.
主要方法:
- 对516名接受ERCP的AC患者进行了回顾性研究.
- MBO (n=56) 和CBDS (n=460) 组之间的比较.
- 倾向性得分匹配 (PSM) 用于控制混因子;主要结果:30天死亡率.
主要成果:
- 在MBO组中,严重AC和延迟ERCP的发病率更高.
- 在MBO组中,30天死亡率,ICU入院率和再入院率显著上升.
- 住院时间对于MBO患者来说是显著更长的,即使在PSM之后.
结论:
- 与普通胆道结石相比,恶性胆道阻塞与更糟糕的AC结果有关.
- 在MBO患者中延迟ERCP有助于预后较差.
- 建议对MBO患者推快速ERCP进行胆汁排水,可疑有AC.
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