对胆道泄漏进行内镜胆道排水的最佳时间:多中心,回顾性,临床研究
De-Xin Chen1,2, Kai-Xuan Fang1,2,3, Sheng-Xin Chen1
1Department of Gastroenterology and Hepatology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China.
World journal of gastrointestinal surgery
|March 31, 2025
概括
在胆道泄漏 (BDLs) 的三个星期内,早期内镜逆行胆道瘤造影 (ERCP) 提高了成功率并降低了收缩风险. 如果保守管理失败,建议立即使用ERCP.
科学领域:
- 胃肠病学 胃肠病学
- 外科手术的结果
- 肝胆道手术 肝胆道手术
背景情况:
- 胆道泄漏 (BDLs) 是一个重要的术后并发症.
- 保守的管理与排水是最初的方法.
- 延迟干预可能会导致胆道狭窄和ERCP时间不足.
研究的目的:
- 在BDL中确定ERCP的最佳时间.
- 为了平衡ERCP的成功与胆道狭窄风险.
- 定义可接受的保守管理持续时间.
主要方法:
- 在448名BDLs患者的多中心回顾性研究中.
- ERCP时间组:3,7,14和21天.
- 主要结局:临床成功;次要结局:胆道狭窄.
主要成果:
- 94名患者接受了ERCP,临床成功率为84%.
- 3周内ERCP的成功率更高 (92%vs75%) 和狭窄率更低 (18%vs45.5%).
- 多变量分析证实了早期ERCP的好处 (成功的OR为4.168,狭窄的OR为0.256).
结论:
- 早期ERCP (3周内) 对于BDLs与更好的结果有关.
- 建议在不对保守治疗有反应的BDL时立即进行ERCP.
相关概念视频
Endoscopic Procedures V: ERCP
44
Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...
Patient...
44
Acute Pancreatitis II: Clinical Manifestations and Management
75
Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
75
Chronic Pancreatitis II: Collaborative Care
50
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
50
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
34
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
34
Endoscopic Studies II: Thoracocentesis
178
Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
178
Endoscopic Studies I: Bronchoscopy and Thoracoscopy
152
Endoscopy is a non-surgical medical technique used to examine a person's internal organs and vessels. This lesson will focus on two types of endoscopic studies: bronchoscopy and thoracoscopy.
Bronchoscopy
Description
Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due...
Bronchoscopy
Description
Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due...
152


