Application of digital cholangioscope-assisted bedside one-stage lithotomy and biliary drainage for severe acute cholangitis (with video)
10.3760/cma.j.cn321463-20240424-00149
- VernacularTitle:新型胆道镜辅助床旁一期取石及引流术在急性重症胆管炎中的应用（含视频）
- Author:
Yadong FENG
1
;
Yan LIANG
;
Yang LIU
;
Yinqiu ZHANG
;
Lihua REN
;
Ruihua SHI
Author Information
1. 东南大学附属中大医院消化科，南京 210029
- Keywords:
Cholangitis;
Choledocholithiasis;
Bedside endoscopic intervention;
Digital cholangioscope
- From:
Chinese Journal of Digestive Endoscopy
2024;41(11):871-876
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To access the therapeutic efficacy of newly-designed digital cholangioscope-assisted bedside one-stage lithotomy and biliary drainage for severe acute cholangitis caused by choledocholithiasis.Methods:Data of 26 patients were retrospectively analyzed, who were admitted into the intensive care unit (ICU), Zhongda Hospital, Southeast University, due to choledocholithiasis induced by severe acute cholangitis and underwent cholangioscope-assisted bedside one-stage lithotomy and biliary drainage from June 2020 to February 2022. Clinical outcomes were analyzed.Results:The time interval from disease onset to endoscopic intervention was 36.2±15.5 hours, with 7.2±4.9 hours from ICU admission to endoscopic intervention. Technical success rate was 100.0% in one-stage stone removal and biliary drainage. Except for one mild pancreatitis, no other complication occurred. Acute physiology and chronic health evaluation (APACHE)Ⅱ and sequential organ failure assessment (SOFA) scores prior to endoscopic intervention were 25.2±6.6 and 11.9±3.5, respectively. APACHE Ⅱ scores at day 1, 3, and 7 after endoscopic intervention were 21.7±6.5, 17.2±6.8 and 12.7±7.7, respectively, and SOFA scores were 10.6±2.9, 8.4±3.0 and 5.4±3.7, respectively, all of them were lower than those before operation ( P<0.001). The lengths of ICU stay and total hospitalization were 9.7±5.0 days and 12.8±4.5 days, respectively. In-hospital mortality occurred in 3 (11.5%) patients. According to a 6-month follow-up, one patient died of pneumonia, and another died of acute myocardial infarction. No acute cholangitis re-occurred in those survivors. Conclusion:Newly-designed digital cholangioscope-assisted bedside one-stage lithotomy and biliary drainage demonstrate significant improvements in prognosis, highlighting its safety in managing severe acute cholangitis.
