Emergency endoscopic treatment of acute obstructive suppurative cholangitis
10.3760/cma.j.issn.1007-5232.2017.04.008
- VernacularTitle:急性梗阻性化脓性胆管炎急诊内镜治疗方法的研究
- Author:
Zhengfeng WANG
;
Wence ZHOU
;
Hui ZHANG
;
Long MIAO
;
Lei ZHANG
;
Wenbo MENG
- Keywords:
Emergency;
Cholangitis;
Endoscopic therapy
- From:
Chinese Journal of Digestive Endoscopy
2017;34(4):259-261
- CountryChina
- Language:Chinese
-
Abstract:
Objective To determine the best endoscopic treatment for acute obstructive suppurative cholangitis (AOSC).Methods Data of 93 patients who were diagnosed as having AOSC in endoscopic center in the last three years were retrospectively analyzed.All patients were divided into three groups according to the different treatment methods:ENBD group,ENBD+ERBD group and double ERBD group.Postoperative temperature,bilirubin levels and mortality were compared.Results For patients with high level obstruction,incidence of fever in ENBD+ERBD group and double ERBD group were significantly higher than that of ENBD group (1/18 VS 4/10,P ＜ 0.05;0 VS 4/10,P ＜ 0.05).There were no significant differences in incidence of fever(1/18 VS 0) or bilirubin level decrease (17/18 VS 14/15) between ENBD+ERBD group and double ERBD group.For high level obstruction,if the patient had biliary imaging with contrast medium during operation,they would have higher incidence of high fever[(4/10 VS 3.45％ (1/28)] and mortality(3/11 VS 0),lower declining rate of bilirubin level [10/14 VS 96.55％(28/29)] than those without.Conclusion Both left and right hepatic ducts drainage should be recommended for high level biliary obstruction.During the operation,contrast medium should be limited to minimum dose,and should be avoided in high level obstruction cases.Air biliary imaging could be used when necessary.
