对"手术优先"与"内镜优先"的比较分析,用于在周末出现的儿科胆固醇结石病
Garrett R Reid1, Jessica L Rauh1, Bonnie E Laingen1
1Department of General Surgery, Section of Pediatric Surgery, Atrium Health Wake Forest Baptist, Wake Forest School of Medicine, Winston Salem, NC, USA.
The American surgeon
|May 4, 2024
概括
与内镜检查相比,手术为儿童胆固醇病的首要方法显著减少了住院时间和治疗时间,特别是在周末入院. 这种策略还需要更少的永久护理程序.
科学领域:
- 儿科手术 儿科手术
- 胃肠病学 胃肠病学
- 胆道疾病 胆道疾病
背景情况:
- 儿童胆固醇病通常使用"内镜首先" (EF) 策略进行治疗,涉及单独麻醉剂下的ERCP和LC.
- 在周末 (EoW) 时,内镜逆行性胆血管细胞造影的可用性有限.
- 使用LC,IOC和LCBDE的"手术第一" (SF) 方法可以减少逗留时间 (LOS) 和最终干预时间 (TTDI).
研究的目的:
- 为了比较"手术第一" (SF) 与"内镜第一" (EF) 策略对儿科胆道胆病的结果.
- 评估介绍时间 (工作周与周末) 对LOS和TTDI的影响.
- 在SF方法中确定腹腔镜常见胆道探索 (LCBDE) 的有效性.
主要方法:
- 对疑似胆固醇胆病的儿科患者进行了回顾性单中心队列研究 (2018-2023年).
- 患者根据表现时间分类:工作周 (WW) 或周末 (EoW).
- 与SF和EF组之间的LOS和TTDI的比较,TTDI定义为时间到LC.
主要成果:
- 分析了88名患者;61名在SF和27名在EF组.
- SF组在 WW 和 EoW 介绍中显示出明显较短的平均 LOS.
- SF方法导致了较短的TTDI趋势,并且需要更少的程序 (69%对EF的100%).
结论:
- 在EoW呈现的儿科胆道胆病与较长的LOS和TTDI有关,特别是EF通路.
- SF方法提供了更少的LOS和更少的程序,无论介绍时间如何.
- 在SF组中,LCBDE表现出高的成功率,无论演示时间如何.
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