在结肠炎与败血症引起的凝血病的内镜胆道排水过程中进行切切除术,增加出血,但没有临床益处
Yasuhisa Hiroshima1, Ryota Sagami2, Naosuke Kuraoka3
1Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan.
概括
透视缩切除术 (EST) 增加了急性胆管炎 (AC) 患者的出血风险,这些患者患有败血症诱导的凝血病 (SIC). 没有EST的胆汁排水可以最大限度地减少出血,同时保持临床结果.
科学领域:
- 胃肠病学 胃肠病学
- 肝病学 肝病学是一种肝病学.
- 内镜手术 进行内镜手术
背景情况:
- 急性胆道炎 (AC) 是一种严重的疾病,需要紧急胆道排水.
- 内镜胆道排水 (EBD) 与内镜切除术 (EST) 是常见的,但会带来出血风险,特别是在发生败血症引起的凝血病 (SIC) 的患者中.
研究的目的:
- 为了评估不良事件 (AEs) 和临床结果的EBD与或没有EST在AC患者与SIC.
主要方法:
- 追溯的多中心队列研究.
- 倾向性得分匹配用于比较EST和非EST组之间的结果.
- 主要终点:AE速率差异;次要终点:临床结果.
主要成果:
- 在EST组中,AE发生率较高,特别是出血 (16.7%对1.8%).
- 在ERCP后的胰腺炎 (PEP) 发病率在各组之间没有显著差异 (4.2%对1.2%).
- 临床成功或28天生存率没有显著差异.
结论:
- 在SIC的AC患者中,EST显著增加了出血风险.
- 没有EST的EBD有效地减少出血风险,而不会影响胆道排水或临床结果.
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