Timing of endoscopic therapy of obstructive acute biliary pancreatitis
10.3760/cma.j.issn.1673-4904.2010.20.006
- VernacularTitle:梗阻型胆源性胰腺炎内镜治疗时机及疗效的临床分析
- Author:
Qidong ZHANG
- Publication Type:Journal Article
- Keywords:
Pancreatitis;
Cholestasis;
Postoperative complications;
Therapy
- From:
Chinese Journal of Postgraduates of Medicine
2010;33(20):14-16
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the timing of endoscopic therapy of obstructive acute biliary pancreatitis. Methods One hundred and sixty cases of obstructive acute biliary pancreatitis treated by endoscopy were analyzed. The patients were divided into two groups:78 cases received emergency endoscopic therapy (EE group) within 48 hours from onset of symptoms,including endoscopic retrograde cholangiopan-creatography and endoscopic sphincterotomy,with or without stone extraction and endoscopic nasobiliary drainage;82 cases received delay endoscopic therapy (DE group) after initial 48 hours of conservative management Results The total success rate of therapeutic endoscopy was 96.2 % (154/160). In EE group, the time for disappearance of abdominal pain [(4.98±1.75)d],the time for laboratory recovery [(10.08± 5.22) d],and the length of hospitalization [(12.24 ± 7.20) d] were significantly shorter than those in DE group [(5.54±2.53),(12.93 ±6.60),(16.38 ±6.94) d](P<0.05 or <0.01). In cases with severe acute biliary pancreatitis,the morbidity in the EE group (9.6% ,5/52) was significantly lower than DE group (23.6%,13/55) (P<0.05),but the difference in mortality rate between the two groups was not significant (P>0.05). Conclusions In severe acute biliary pancreatitis patients with biliary tract obstruction, emergency endoscopic therapy should be performed within 48 hours from the onset of symptoms. Patients with mild acute biliary pancreatitis should also undergo prompt endoscopic therapy after ineffective conservative management or appearance of symptoms of acute biliary tract infection.
