Analysis of clinical diagnosis and treatment in 63 patients with emergency biliary obstruction
10.3760/cma.j.issn.1008-1372.2020.01.003
- VernacularTitle: 63例急诊胆道梗阻患者临床诊疗分析
- Author:
Hongtao WEI
1
;
Tianpeng ZHANG
;
Bing LIU
;
Jiandong ZHANG
;
Guoxing WANG
Author Information
1. Department of Emergency, Emergency and Critical Care Center of Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
- Publication Type:Journal Article
- Keywords:
Choledocholithiasis;
Bile duct neoplasms;
Biliary obstruction;
Cholangiopancreatography, magnetic resonance;
Emergency treatment;
Biliary tract surgery procedures
- From:
Journal of Chinese Physician
2020;22(1):8-11
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To improve the awareness of emergency biliary obstruction (BO) disease, and to further improve the diagnosis and treatment ability of BO patients.
Methods:Data of the etiology, clinical manifestations, imaging data, laboratory tests, and emergency treatment outcomes in 63 BO patients were retrospectively analyzed.
Results:Common bile duct stones were the most common cause of BO patients (63.49%), followed by cholangiocarcinoma (19.05%); the most common clinical manifestations of BO patients were jaundice (90.48%), abdominal pain (87.30%), and fever (53.97%); the diagnostic ability of computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP) in patients with BO was significantly higher than that of ultrasound (P<0.05), but there was no significant difference between CT and MRCP (P=1.000); compared with benign group, hemoglobin and albumin in malignant group were significantly lower, while total bilirubin and direct bilirubin were higher, with statistically significant difference (P<0.05). Most patients in BO patients improved after treatment, and the mortality rate of BO patients was 3.17%(2/63) at the end of emergency visit.
Conclusions:Common bile duct stones and cholangiocarcinoma are still the most common causes of emergency BO patients. The most common clinical manifestations of patients with emergency BO are jaundice, abdominal pain, and fever. Better than abdominal ultrasound, CT and MRCP have comparable diagnostic capabilities in the diagnosis of emergency BO patients. Anemia, hyperbilirubinemia and hypoproteinemia are alarm indicators for malignant tumors in emergency BO patients. Most patients can temporarily get better at the end of emergency visit.
