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对胆道干预的ERCP和PTBD进行比较分析,以了解再接收率和患者结果

Daniel Huai-En Wang¹, Patrick Chang², Supisara Tintara²

¹Department of Internal Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA.

Journal of clinical gastroenterology

|September 23, 2024

概括

内镜逆行胆血管细胞造影 (ERCP) 显示,对于胆道阻塞的皮肤透肝胆道排水 (PTBD) 比胆道阻塞的结果更好,再接收率和死亡率更低. 对内镜超声波引导胆道排水 (EUS-BD) 的进一步研究可能为未来的替代方案提供了选择.

科学领域:

胃肠病学胃肠病学
干预性内镜检查是干预性的内镜检查.
胆汁干预胆汁干预

背景情况:

胆道阻塞的管理通常涉及ERCP和PTBD.
需要进一步澄清ERCP和PTBD之间的比较结果.

研究的目的:

为了比较ERCP和PTBD之间的再接收率和住院结果.
评估这些胆汁排水程序的利用和有效性.

主要方法:

从2016年至2020年对国家再接收数据库 (NRD) 的分析.
倾向性得分匹配用于比较ERCP和PTBD队列.
主要结局包括30天,90天和6个月的再入院率;次要结局包括死亡率,成本和停留时间.

主要成果:

与ERCP相比,PTBD与更高的30天和90天再入院率有关.
此外,PTBD还显示住院时间,住院费用和整体死亡率增加.
在任何时间点,在重新接收者之间没有观察到死亡率的显著差异.

结论:

关于再接收率,停留时间和整体死亡率,ERCP表现出优于PTBD的结果.
在ERCP失败的情况下,内超声引导胆管排水 (EUS-BD) 是一个有前途的替代方案,特别是在经验丰富的中心.

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