内镜逆行胆管胰造影(ERCP)后早期与延迟腹腔镜胆囊切除术去除胆总管结石:一份循证病例报告

Fauzan Hertrisno Firman, Gerald Abraham Harianja, H. Maulahela
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引用次数: 0

摘要

目的:通过比较早期腹腔镜胆囊切除术与延迟腹腔镜胆囊切除术的疗效,探讨内镜逆行胆管造影(ERCP)后胆总管结石患者的首选治疗方法。方法:按照纳入标准和排除标准在PubMed和Cochrane两个数据库中进行文献检索。我们对两项随机临床试验(RCT)的有效性、重要性和适用性进行了严格的评价。结果:ERCP术后早期腹腔镜胆囊切除术在复发胆总管结石、急性胆囊炎、住院时间和治疗费用方面的发生率较低(p < 0.05)。两组在胆道粘连发生率、胆囊切除术出血发生率、总胆红素、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、谷氨酰转移酶(GGT)等实验室指标比较,差异均无统计学意义(p 0.05)。结论:ERCP切除后胆总管结石建议在术后3天内进行早期胆囊切除术。
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Early Versus Delayed Laparoscopic Cholecystectomyafter Endoscopic Retrograde Cholangio-Pancreatography (ERCP) Removal of Choledocholithiasis: An Evidence-based Case Report
Aim: To determine the preferred method of treatment in patients with choledocholithiasis after endoscopic retrograde cholangiopancreatography (ERCP) by evaluating efficacy of early laparascopic cholecystectomy compared to delayed laparoscopic cholecystectomy.Method: Literature searching was carried out on two databases, PubMed and Cochrane, according to the inclusion and exclusion criteria. Two randomized clinical trial (RCT) studies were appraised critically for validity, importance, and applicability.Results: Early laparascopic cholecystectomy after ERCP shows lower outcomes in incidence of recurrent choledocholithiasis, acute cholecystitis, duration of hospitalization, and treatment costs (p 0.05). Meanwhile, there was no significant difference (p 0.05) between the two groups regarding the incidence of biliary adhesions, bleeding during cholecystectomy, and laboratory parameters such as total bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma glutamyl transferase (GGT).Conclusion: Early cholecystectomy, within three days after ERCP, is recommended for the treatment of choledocholithiasis after ERCP removal.
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