急性胆管炎的胆道减压时机。
Timing of biliary decompression for acute cholangitis.
机构信息
Central Laboratory, The Third Affiliated Hospital, Qiqihar Medical University, Qiqihar 161000, Heilongjiang Province, China.
Department of Medical Oncology, The Third Affiliated Hospital, Qiqihar Medical University, Qiqihar 161000, Heilongjiang Province, China.
出版信息
World J Gastroenterol. 2023 Feb 7;29(5):904-907. doi: 10.3748/wjg.v29.i5.904.
Severe acute cholangitis (AC) exacerbates the risk of death because of the rapid progression of the disease. The optimal timing of biliary decompression (BD) as a necessary intervention in patients with severe AC is controversial. A recently report titled "Timing of endoscopic retrograde cholangiopancreatography in the treatment of acute cholangitis of different severity" in the that the optimal time of endoscopic retrograde cholangiopancreatography for treating patients with severe AC is ≤ 48 but not ≤ 24 h, providing clinical evidence for selecting the optimal time for implementation of BD. Here, we discuss the controversy over the optimal timing of BD for AC based on guidelines and clinical evidence, and consider that more high-level clinical researches are urgent needed to benefit the management of patients with different severity of AC.
严重急性胆管炎（AC）由于疾病的快速进展，增加了死亡风险。作为严重 AC 患者的必要干预措施，胆道减压（BD）的最佳时机存在争议。最近发表在《柳叶刀》杂志上的一篇题为“不同严重程度急性胆管炎内镜逆行胰胆管造影治疗时机”的研究报告指出，内镜逆行胰胆管造影治疗严重 AC 的最佳时间为≤48 小时而不是≤24 小时，为选择 BD 的最佳时机提供了临床依据。在这里，我们根据指南和临床证据讨论了 AC 最佳 BD 时机的争议，并认为迫切需要更多的高级别临床研究，以利于不同严重程度 AC 患者的管理。
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