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内镜逆行胰胆管造影术治疗妊娠患者症状性胆总管结石的结果:墨西哥城一家二级保健医院的近期经验。

Endoscopic retrograde cholangiopancreatography results for the treatment of symptomatic choledocholithiasis in pregnant patients: A recent experience at a secondary care hospital in Mexico City.

机构信息

Departamento de Cirugía General y Endoscópica, Hospital General Dr. Manuel Gea González, SSA, Ciudad de México, México.

Departamento de Cirugía General y Endoscópica, Hospital General Dr. Manuel Gea González, SSA, Ciudad de México, México.

出版信息

Rev Gastroenterol Mex (Engl Ed). 2021 Jan-Mar;86(1):21-27. doi: 10.1016/j.rgmx.2019.12.001. Epub 2020 Mar 18.

Abstract

INTRODUCTION

Endoscopic retrograde cholangiopancreatography (ERCP) is the treatment of choice for symptomatic choledocholithiasis during pregnancy. In pregnant patients, aside from the risks inherent in the procedure and sedation, there is the added concern of the potentially damaging effects of ionizing radiation on the fetus.

AIM

To describe the maternal and fetal results of ERCP performed to resolve symptomatic choledocholithiasis in pregnant patients.

MATERIALS AND METHODS

A retrospective, descriptive, observational, and cross-sectional study was conducted. It included pregnant patients with choledocholithiasis that underwent ERCP within the time frame of June 2017 and June 2018.

RESULTS

The study included 9 pregnant patients, with a mean gestational age of 24.1 weeks, that underwent ERCP. There were no maternal or fetal complications associated with sedation, mean fluoroscopy time was 26.7seconds, and one patient (11.1%) presented with mild post-ERCP pancreatitis that was resolved through medical management. Pregnancy progression was normal in 100% of the cases, resulting in the birth of neonates with a normal Apgar score, a mean weight of 3,120g, a mean length of 49.94cm, and a mean gestational age of 38.37 weeks. At follow-up at 6 months, the infants had a mean weight of 7.1kg and a mean length of 66.94cm.

CONCLUSIONS

The results from our hospital center were similar to those described in the international literature, showing that ERCP in our medical environment is a feasible, safe, and efficacious method for both the mother and fetus. When performed by an experienced endoscopist, it should be considered the treatment of choice for choledocholithiasis in pregnant patients.

摘要

简介

经内镜逆行胰胆管造影术(ERCP)是治疗妊娠期症状性胆总管结石的首选方法。在孕妇中,除了手术和镇静本身固有的风险外,还有电离辐射对胎儿潜在的有害影响的额外担忧。

目的

描述为解决孕妇症状性胆总管结石而行 ERCP 的母婴结果。

材料和方法

进行了一项回顾性、描述性、观察性和横断面研究。它包括在 2017 年 6 月至 2018 年 6 月期间接受 ERCP 的患有胆总管结石的孕妇。

结果

该研究包括 9 名孕妇,平均妊娠 24.1 周,行 ERCP。无与镇静相关的母亲或胎儿并发症,平均透视时间为 26.7 秒,1 名患者(11.1%)出现轻度 ERCP 后胰腺炎,经药物治疗后缓解。100%的病例妊娠进展正常,新生儿 Apgar 评分正常,平均体重为 3120g,平均长度为 49.94cm,平均妊娠周数为 38.37 周。随访 6 个月时,婴儿平均体重为 7.1kg,平均长度为 66.94cm。

结论

我们医院中心的结果与国际文献描述的结果相似,表明在我们的医疗环境中,ERCP 对母亲和胎儿都是可行、安全和有效的方法。当由经验丰富的内镜医生进行操作时,它应被视为治疗孕妇胆总管结石的首选方法。

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