Anselmi M, Salgado J, Arancibia A, Alliu C
Departamento de Cirugía, Facultad de Medicina, Universidad de Concepción, Unidad de Cirugía Endoscópica, Servicio de Cirugía, Hospital Guillermo Grant B, Concepción, Chile.
Rev Med Chil. 2001 Jul;129(7):757-62.
Endoscopic drainage of the biliary tree for acute cholangitis is a therapeutic modality with a lower mortality and complication rates.
To compare endoscopic drainage with surgical treatment in the emergency management of acute cholangitis.
Between 1995 and 1998, sixty five patients with acute cholangitis were subjected to an endoscopic drainage of the biliary tree. In the same period, 40 patients were treated with traditional surgical procedures. The evolution of both groups of patients were compared.
Sixty two patients (95.4%) subjected to endoscopic treatment had a satisfactory evolution, compared with 23 (58%) of those operated (p < 0.001). Five operated patients and no individual subjected to endoscopic drainage died (p < 0.01). Mean postoperative hospital stay of operated patients was 15.5 +/- 19.6 days compared to 5.8 +/- 4.2 days in those subjected to endoscopic drainage (p < 0.001). Definitive resolution of biliary obstruction was achieved in 83% of patients subjected to endoscopic drainage or traditional surgery.
Endoscopic drainage has a lower rate of complications and mortality than traditional surgery, in the treatment of acute cholangitis.
内镜下胆管引流术治疗急性胆管炎是一种死亡率和并发症发生率较低的治疗方式。
比较内镜引流术与手术治疗在急性胆管炎急诊处理中的效果。
1995年至1998年间，65例急性胆管炎患者接受了内镜下胆管引流术。同期，40例患者接受了传统手术治疗。比较两组患者的病情发展。
接受内镜治疗的62例患者（95.4%）病情发展良好，而接受手术治疗的患者中只有23例（58%）病情发展良好（p < 0.001）。接受手术治疗的患者中有5例死亡，接受内镜引流术的患者无死亡病例（p < 0.01）。接受手术治疗的患者术后平均住院时间为15.5 +/- 19.6天，而接受内镜引流术的患者为5.8 +/- 4.2天（p < 0.001）。接受内镜引流术或传统手术的患者中，83%的患者胆管梗阻得到彻底解决。
在治疗急性胆管炎方面，内镜引流术的并发症发生率和死亡率低于传统手术。
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