胆囊切除术与内科手术的内镜逆行胆囊瘤学:顺序是否重要?
João de Bona Castelan Filho1, Arthur Pizzolatti Zapelini1, Felipe Antônio Cacciatori1,2,3
1Hospital São José, General Surgery Service - Criciúma (SC), Brazil.
概括
胆囊切除术 (CCT) 和内镜逆行胆血管细胞切除术 (ERCP) 的顺序不会影响胆囊胆固醇胆固醇病的结果. 淋巴缺血和胆囊炎可能预测胆道清除失败.
科学领域:
- 胃肠病学 胃肠病学
- 手术创新 在外科创新.
- 胆道疾病 胆道疾病
背景情况:
- 胆固醇胆固醇胆固醇胆病的治疗通常涉及胆固醇胆固醇切除术 (CCT) 与内镜逆行胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇胆固醇.
- 与ERCP一起的手术内CCT提供了更高的成功率,减少住院时间和更低的成本.
- 在现有的文献中,CCT和ERCP的最佳顺序仍然不清楚.
研究的目的:
- 为了确定与CCT相对的手术内ERCP序列是否会影响患者的结果和并发症率.
- 为了比较在单一程序中执行ERCP在CCT之前和之后的疗效和安全性.
主要方法:
- 追溯病例控制研究分析了与手术内ERCP一起接受CCT的患者.
- 研究期:2021年1月至2022年6月.
- 背景:巴西南部的第三级医院,专注于胆固醇胆固醇胆病例.
主要成果:
- 在37名患者中,16名 (43.2%) 在CCT之前进行了ERCP.
- 总体上,胆道管成功率为91.9%,其中75.7%的胆道清除. 在ERCP后发生的胰腺炎发生在10.8%的人群中.
- 在CCT技术难度上没有显著差异. "CCT第一"组表现出更高的胆道管成功率 (p=0.020). 年轻的年龄,远端CBD石头和较短的手术持续时间与成功清除相关. 淋巴缺血和胆囊炎与清除失败有关.
结论:
- 在同一程序中,CCT和ERCP的序列不会显著改变并发症率或胆道清除成功率.
- 淋巴缺血和胆囊炎被确定为失败胆道清除的预测因素.
- 这一发现支持了在管理胆固醇胆固醇胆固醇胆病时的程序灵活性.
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