The efficacy of endoscopic retrograde cholangiopancreatography combined with endoscopic nasobiliary drainage in the treatment of acute obstructive suppurative cholangitis
10.3760/cma.j.cn115455-20240517-00414
- VernacularTitle:内镜逆行胰胆管造影联合内镜鼻胆管引流术治疗急性梗阻化脓性胆管炎的疗效
- Author:
Wei XU
1
;
Yanping ZHANG
1
;
Lifei WU
1
Author Information
1. 安庆市立医院消化内科，安庆 246000
- Publication Type:Journal Article
- Keywords:
Cholangitis;
Endoscopic retrograde cholangiopancreatography;
Endoscopic nasobiliary drainage;
Laparoscopic common bile duct exploration;
Comparative study
- From:
Chinese Journal of Postgraduates of Medicine
2025;48(4):322-325
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical efficacy of endoscopic retrograde cholangiopancreatography (ERCP) combined with endoscopic nasobiliary drainage (ENBD) in the treatment of acute obstructive suppurative cholangitis (AOSC).Methods:A total of 72 patients with AOSC admitted to Anqing Municipal Hospital from September 2021 to July 2023 were selected prospectively, and they were divided into two groups according to random number table method, each with 36 patients. The endoscopic group underwent ERCP+ENBD, while the surgical group underwent laparoscopic common bile duct exploration (LCBDE). The treatment effectiveness, clinical symptom improvement time, liver function indicators, inflammatory factors and complications between the two groups were compared.Results:The total effective rate in the endoscopic group was higher than that in the surgical group: 97.22% (35/36) vs. 77.78% (28/36), there was statistical difference ( χ2 = 4.57, P<0.05). The disappearance time of abdominal pain, recovery time of gastrointestinal function, and hospitalization time in the endoscopic group were shorter than those in the surgical group: (2.76 ± 0.65) d vs. (3.35 ± 0.72) d, (3.08 ± 0.83) d vs. (5.13 ± 1.07) d, (8.45 ± 1.26) d vs. (10.69 ± 1.48) d, there were statistical differences ( P<0.05). The levels of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), glutamyltranspeptidase (GGT), procalcitonin (PCT), C-reactive protein (CRP) in the two groups befor surgery had no statistical differences ( P>0.05). The levels of ALT, AST, GGT, PCT and CRP were decreased at 24 and 48 h after surgery in both groups, and the above indexes in the endoscopic group were lower than those in the surgical group: at 24 h after surgery: (42.18 ± 5.12) U/L vs. (48.53 ± 6.06) U/L, (60.25 ± 8.57) U/L vs. (69.13 ± 10.13) U/L, (155.74 ± 24.61) U/L vs. (171.45 ± 20.85) U/L, (2.67 ± 0.40) μg/L vs. (3.09 ± 0.52) μg/L, (38.72 ± 5.21) mg/L vs. (44.16 ± 7.83) mg/L; at 48 h after surgery: (34.22 ± 4.74) U/L vs. (39.17 ± 5.83) U/L, (34.10 ± 5.18) U/L vs. (38.52 ± 6.06) U/L, (124.57 ± 20.53) U/L vs. (147.82 ± 16.81) U/L, (1.13 ± 0.27) μg/L vs. (1.46 ± 0.33) μg/L, (20.14 ± 3.75) mg/L vs. (27.39 ± 5.28) mg/L, there were statistical differences ( P<0.05). The complications between the two groups had no statistical difference ( P>0.05). Conclusions:ERCP + ENBD in the treatment of AOSC patients can significantly improve the clinical efficacy, alleviate inflammatory reactions, improve liver function, promote disease recovery, and have high safety.
