由常见胆道结石引起的急性胆道炎的一阶段和两阶段内镜治疗:一项回顾性多中心队列研究
Akinori Maruta1, Takuji Iwashita2, Kensaku Yoshida1
1Department of Gastroenterology, Gifu Prefectural General Medical Center, Gifu, Japan.
Journal of hepato-biliary-pancreatic sciences
|March 18, 2024
概括
由于常见的胆道结石 (CBDS) 引起的急性胆道炎的单阶段内镜治疗可以减少住院时间,但需要对潜在的复发进行仔细的随访. 两阶段的治疗有较高的ERCP后胰腺炎的发病率.
科学领域:
- 胃肠病学 胃肠病学
- 内镜逆行胆血管细胞造影 (ERCP) 是一种内镜逆行胆血管细胞造影.
- 胆道疾病 胆道疾病
背景情况:
- 急性胆道炎通常是由常见的胆道结石 (CBDS) 引起的.
- 一阶段内镜治疗 (同时进行乳头干预和石头去除) 是一种潜在的治疗方法.
- 仅有有限的数据可以比较CBDS诱导的急性胆道炎的一阶段和两阶段治疗.
研究的目的:
- 为了比较一阶段和两阶段内镜治疗CBDS引起的急性胆道炎的短期和长期结果.
主要方法:
- 对577名接受一次或两阶段内镜治疗急性胆道炎的患者进行了回顾性研究 (2010年5月 - 2020年12月).
- 患者被分为一个阶段和两个阶段的组.
- 两组之间的临床结果进行了比较.
主要成果:
- 在各组之间,技术和临床成功率相似.
- 一个阶段的管理导致住院时间显著缩短.
- 两阶段组的ERCP后胰腺炎发病率显著更高 (10.0%对3.4%).
- 一阶段组的累积晚期不良事件率较高 (22.6%对14.1%).
- 与CBDS复发相关的因素包括单阶段干预,多种结石 (≥2),胆管排水,ML使用和胆囊结石.
结论:
- 一阶段内镜治疗是有效和安全的,减少了CBDS引起的急性胆道炎的住院时间.
- 认真的术后随访对于监测CBDS复发至关重要.
- 复发的风险因素需要在患者管理中考虑.
关键词:
急性胆管炎是什么情况常见的胆道结石 胆道结石内镜逆行性胆血管造机图 (cholangiopancreatography) 是一种内镜逆行式胆血管造机图 (cholangiopancreatography).一个阶段的单阶段.更多相关视频
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