Predicting the success of endoscopic transpapillary gallbladder drainage for patients with acute cholecystitis during pretreatment evaluation
Predicting the success of endoscopic transpapillary gallbladder drainage for patients with acute cholecystitis during pretreatment evaluation
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DOI：
10.1155/2008/702516
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发表时间：
2008-08-01
期刊：
影响因子：
--
通讯作者：
Yoshiba, Makoto
中科院分区：
文献类型：
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作者：
Ogawa, Osamu;Yoshikumi, Hiroki;Yoshiba, Makoto
简介：虽然内镜下经乳头胆囊引流术（ETGBD）已被报道是急性胆囊炎的有效治疗方法，但技术上的困难阻碍了这项技术的广泛应用。病例评估，可以predeict发生这种困难，应增加接受ETGBD急性胆囊炎treatment.Objective：建立一个治疗前评估方案为急性胆囊炎patients with acute cholecystitis.METHODS：11例急性胆囊炎患者接受ETGBD在2003年或2004年纳入本回顾性研究。成功的频率，并发症和整体效果的ETGBD成功，包括临床和实验室参数，和胆囊超声检查，也evaluated.Results：ETGBD是成功的11例（成功率63.6%）。所有7名成功接受ETGBD的患者在几天内均无发热和无症状。没有临床或实验室变量与ETGBD的成功显著相关。相比之下，超声测量胆囊短轴长度和壁厚在成功的情况下，显着较短（27.4 mm vs 38.0 mm; P=0.008）和更薄（4.2 mm vs 9.0 mm; P=0.041）。结论：胆囊的超声测量-在急性胆囊炎患者的术前评估中，轴长和壁厚可作为ETGBD技术难度的重要评估指标。
INTRODUCTION: Although endoscopic transpapillary gallbladder drainage (ETGBD) has been reported to be an effective treatment for acute cholecystitis, technical difficulties have precluded more widespread use of this technique. Case evaluations that can predeict the occurrence of such difficulties should increase the acceptance of ETGBD for acute cholecystis treatment.OBJECTIVE: To establish a pretreatment evaluation protocol for patients with acute cholecystitis.METHODS: Eleven patients with acute cholecystitis who received ETGBD in 2003 or 2004 were enrolled in the present rettrospective study. The frequency of success, complications and overall effectiveness of ETGBD success, including clinical and laboratory parameters, and gallbladder ultrasonograms, were also evaluated.RESULTS: ETGBD was successful in seven of 11 patients (success rate 63.6%). All seven patients who underwent ETGBD successfully were afebrilic and asymptomatic within a few days. No clinical or laboratory variables were significantly associated with success of ETGBD. In contrast, ultrasonographic measures of gallbladder minor-axis length and wall thickness in successful cases were significantly shorter (27.4 mm versus 38.0 mm; P=0.008) and thinner (4.2 mm versus 9.0 mm; P=0.041) relative to unsuccessful cases.CONCLUSIONS: Ultrasonographic measures of gall bladder minor-axis length and wall thickness can serve as important evaluation of ETGBD technical difficulties during pretreatment evaluation of patients with acute cholecystitis.