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超声引导下经皮胆囊造瘘术作为Ⅱ级或Ⅲ级急性胆囊炎患者的桥接治疗或确定性治疗。

Ultrasound-guided percutaneous cholecystostomy as bridging or definitive treatment in patients with acute cholecystitis grade II or III.

作者信息

Kesim Çağrı, Özen Özgür

机构信息

Başkent University, Konya Hospital, Department of Radiology, Interventional Radiology Section, Turkey.

Başkent University, Ankara Hospital, Department of Radiology, Interventional Radiology Section, Turkey.

出版信息

Heliyon. 2023 Apr 18;9(5):e15601. doi: 10.1016/j.heliyon.2023.e15601. eCollection 2023 May.

DOI:10.1016/j.heliyon.2023.e15601
PMID:37153409
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10160755/
Abstract

BACKGROUND

We aimed to investigate the extent to which ultrasound (US)-guided percutaneous cholecystostomy (PC) is used as a bridging or definitive therapy for grade II and III acute cholecystitis and whether this treatment causes significant changes in C-reactive protein (CRP) and direct bilirubin (DB) levels in the first 72 h and the first three weeks.

METHODS

We included 145 consecutive patients who underwent PC over 17 years. No patient had cirrhosis. PC was performed in the interventional radiology department under US guidance.

RESULTS

US-guided PC was the definitive treatment for more than half of the patients (51.7%) and decreased DB levels significantly more than CRP levels.

CONCLUSION

No statistically significant correlation between those whose CRP and DB levels normalized within three weeks and those who did not and required a second invasive procedure. Nevertheless, the bridging treatment group was significantly older than the definitive treatment group.

摘要

背景

我们旨在研究超声(US)引导下经皮胆囊造瘘术(PC)作为II级和III级急性胆囊炎的桥接治疗或确定性治疗的应用程度,以及这种治疗是否会在最初72小时和前三周内导致C反应蛋白(CRP)和直接胆红素(DB)水平发生显著变化。

方法

我们纳入了17年间连续接受PC治疗的145例患者。所有患者均无肝硬化。PC在介入放射科超声引导下进行。

结果

超声引导下PC是超过半数患者(51.7%)的确定性治疗方法,且DB水平的下降幅度明显大于CRP水平。

结论

在三周内CRP和DB水平恢复正常的患者与未恢复正常且需要进行二次侵入性手术的患者之间,无统计学显著相关性。然而,桥接治疗组的年龄明显大于确定性治疗组。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1eb/10160755/03b372d9af83/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1eb/10160755/4f4cd4f5d5ba/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1eb/10160755/8d560824577a/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1eb/10160755/81ab0d53e611/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1eb/10160755/03b372d9af83/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1eb/10160755/4f4cd4f5d5ba/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1eb/10160755/8d560824577a/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1eb/10160755/81ab0d53e611/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1eb/10160755/03b372d9af83/gr4.jpg

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本文引用的文献

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Am Surg. 2023 Nov;89(11):4424-4430. doi: 10.1177/00031348221109459. Epub 2022 Jul 19.
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Percutaneous cholecystostomy: An update for the 2020s.经皮胆囊造瘘术:2020年代的最新进展
North Clin Istanb. 2021 Oct 6;8(5):537-542. doi: 10.14744/nci.2021.81594. eCollection 2021.
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Surgical outcome of percutaneous transhepatic gallbladder drainage in acute cholecystitis: Ten years' experience at a tertiary care centre.
经皮经肝胆囊引流术治疗急性胆囊炎的手术效果:一家三级保健中心的十年经验。
Surg Endosc. 2022 May;36(5):2850-2860. doi: 10.1007/s00464-021-08573-0. Epub 2021 Aug 20.
4
Total bilirubin trend as a predictor of common bile duct stones in acute cholecystitis and symptomatic cholelithiasis.总胆红素趋势预测急性胆囊炎和有症状胆石症的胆总管结石。
Am J Surg. 2019 Jan;217(1):98-102. doi: 10.1016/j.amjsurg.2018.06.011. Epub 2018 Jun 18.
5
Percutaneous cholecystostomy for high-risk patients with acute cholangitis.经皮胆囊造瘘术用于急性胆管炎高危患者。
Medicine (Baltimore). 2018 May;97(19):e0735. doi: 10.1097/MD.0000000000010735.
6
Clinical characteristics of patients with newly developed acute cholecystitis after admission to the intensive care unit.入住重症监护病房后新发急性胆囊炎患者的临床特征。
Aust Crit Care. 2019 May;32(3):223-228. doi: 10.1016/j.aucc.2018.03.006. Epub 2018 Apr 19.
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Percutaneous Transhepatic Gallbladder Drainage Combined with Laparoscopic Cholecystectomy: A Meta-Analysis of Randomized Controlled Trials.经皮经肝胆道引流联合腹腔镜胆囊切除术:随机对照试验的Meta分析
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Tokyo Guidelines 2018: management strategies for gallbladder drainage in patients with acute cholecystitis (with videos).东京指南 2018:急性胆囊炎患者胆囊引流的管理策略(附视频)。
J Hepatobiliary Pancreat Sci. 2018 Jan;25(1):87-95. doi: 10.1002/jhbp.504. Epub 2017 Nov 21.
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