Gracanin Ana Gudelj, Kujundzić Milan, Petrovecki Mladen, Romić Zeljko, Rahelić Dario
University of Zagreb, Dubrava University Hospital, Department of Clinical Immunology and Rheumatology, Zagreb, Croatia.
Coll Antropol. 2013 Mar;37(1):131-3.
The etiology and epidemiology of obstructive jaundice in Continental Croatia has been studied in 174 patients. The objective of this research was also to explore the importance and efficiency of endoscopic retrograde cholangiopancreatography (ERCP) as a non-surgical method of treatment of obstructive jaundice in the population of Continental Croatia. Obstructive jaundice is the illness of elderly population which is also confirmed by the information on the average age of our patients. The frequency of illness is higher among female population, and the most frequent cause of obstructive jaundice are gallstones (54.1% of patients). In 29.8% of patients the primary or secondary malignant disease was the cause of blockage in gall flow and subsequent jaundice, and the most frequent malignant cause of obstructive jaundice is pancreas cancer in 11.5% of patients. The mean value of serum concentrations of total bilirubin, alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase and gamma glutamiltransferase 24 hours before the biliary decompression by ERCP has been significantly above the upper referential value, and 24 hours after the ERCP it has dropped to normal with their statistically significant difference (p < 0.0001). The normal values of markers for synthetic liver function (total proteins and prothrombin time) have been noticed as well as elevated values of inflammatory markers in obstructive jaundice independently of etiology. Out of the total number of patients, 37.7% required the surgical treatment while 60.3% of patients were treated by ERCP, i.e. either the stone extraction or the implantation of endobiliary stent was performed.
我们对克罗地亚大陆地区174例梗阻性黄疸患者的病因及流行病学特征进行了研究。本研究的目的还在于探讨内镜逆行胰胆管造影术（ERCP）作为克罗地亚大陆地区梗阻性黄疸非手术治疗方法的重要性和有效性。梗阻性黄疸是一种老年疾病，我们患者的平均年龄信息也证实了这一点。女性人群中该病的发病率更高，梗阻性黄疸最常见的病因是胆结石（占患者的54.1%）。在29.8%的患者中，原发性或继发性恶性疾病是胆汁流动受阻及随后黄疸的病因，梗阻性黄疸最常见的恶性病因是胰腺癌，占患者的11.5%。在通过ERCP进行胆道减压前24小时，血清总胆红素、碱性磷酸酶、天冬氨酸转氨酶、丙氨酸转氨酶和γ-谷氨酰转移酶的平均浓度显著高于参考上限值，而在ERCP术后24小时，这些指标降至正常，差异具有统计学意义（p < 0.0001）。在梗阻性黄疸患者中，无论病因如何，均观察到肝功能合成指标（总蛋白和凝血酶原时间）的正常值以及炎症指标的升高值。在所有患者中，37.7%需要手术治疗，而60.3%的患者接受了ERCP治疗，即进行了结石取出或胆道内支架植入。
