对于患有原发性硬化性胆道炎的患者,定期计划进行内镜干预的长期影响
Burcin Özdirik1,2, Wilfried Veltzke-Schlieker1, Jule Marie Nicklaus1
1Department of Hepatology and Gastroenterology, Campus Virchow Klinikum (CVK) and Campus Charité Mitte (CCM), Charité Universitätsmedizin Berlin, Berlin, Germany.
原发性硬化胆道炎 (PSC) 预定的内镜逆行胆道管化图 (ERCP) 改善了无移植生存率. 定期的ERCP干预,无论症状如何,表现出比按需程序更好的结果.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 胃肠病学 胃肠病学
- 干预性内镜检查是干预性的内镜检查.
背景情况:
- 由于胆道阻塞,初级硬化胆道炎 (PSC) 往往需要内镜逆行胆道细胞造影 (ERCP).
- 虽然ERCP的好处是众所周知的,但最佳的后续策略及其对PSC管理的长期影响仍然不清楚.
研究的目的:
- 评估针对PSC患者的结构化,计划化ERCP计划的长期结果.
- 在PSC管理中,比较计划ERCP和按需ERCP之间的无移植生存率 (TFS).
主要方法:
- 对201名接受ERCP的PSC患者的回顾性分析.
- 在预定ERCP的133名患者和仅需ERCP的68名患者之间比较TFS,肝衰竭,胆管炎,恶性病变和不良事件.
- 对胆血管学进展对结果的影响分析.
主要成果:
- 与按需ERCP相比,预定ERCP与初始诊断 (27年 vs. 17年) 和初始呈现 (16年 vs. 11年) 的TFS中位数明显更高.
- 在ERCP之间胆血管学发现的进展与较差的结果相关.
- 两组之间没有发现不良事件的显著差异.
结论:
- 经验丰富的中心有计划的ERCP计划可以改善PSC患者的无移植生存率.
- 这些发现支持通过多中心试验进一步调查,以建立定期的内镜随访作为PSC的疾病修饰策略.
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