急性胆囊造瘘患者经皮胆囊抽吸与经皮胆囊造瘘的比较。单独抽吸胆囊就足够了吗?

Ümmihan Topal, Süleyman Sönmez, Sevinc Dağistanlı
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摘要

背景:本研究的目的是比较经皮胆囊穿刺(PA)和经皮胆囊造口术(PC)治疗AC的疗效和并发症发生率,并介绍单一三线中心的经验。方法:回顾性分析2015 - 2020年我院收治的159例AC患者,因保守治疗无效,无法行LC治疗,均行PA、PC手术。记录PC和PA手术前和术后3天的临床和实验室数据、技术成功、并发症、治疗反应、住院时间和逆转录聚合酶链反应(RT-PCR)检测结果。结果:159例患者中,22例(8男14女)行PA手术,137例(57男80女)行PC手术。PA组和PC组在72 h的临床恢复(P: 0.532)和住院时间(P: 0.138)方面无显著差异。两种手术的技术成功率均为100%。虽然22例PA患者中有20例有明显的恢复,但只有1例接受了两次PA治疗,并观察到完全恢复(4.5%)。两组并发症发生率均较低,差异无统计学意义(P: 1.00)。结论:在本次大流行时期,PA和PC程序是一种有效、可靠、成功的治疗方法,可用于不能进行手术治疗的AC危重患者的床边,对卫生工作者安全,对患者的风险低。对于无并发症的AC患者,应行PA,如果治疗无反应,则应保留PC作为挽救性手术。对于出现并发症且不适合手术的AC患者,应采用PC手术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Comparison of percutaneous gallbladder aspiration with percutaneous cholecystostomy in acute cholecystostomy patients. Can gall bladder aspiration alone be sufficient?

Background: The aim of this study is to compare the efficacy and complication rates of percutaneous gallbladder aspiration (PA) and percutaneous cholecystostomy (PC) in the management of AC and present the experiences of a single third-line center.

Methods: The results of 159 patients with AC who admitted to our hospital between 2015 and 2020, that underwent PA and PC procedures, because they did not respond to conservative treatment and LC could not be performed, were retrospectively analyzed. Clinical and laboratory data before and 3 days after PC and PA procedure, technical success, complications, response to treatment, duration of hospital stay, and reverse transcriptase-polymerase chain reaction (RT-PCR) test results were recorded.

Results: Out of 159 patients, 22 (8 men 14 women) underwent PA procedure and 137 (57 men 80 women) underwent PC. No significant difference was detected between the PA and PC groups in terms of clinical recovery (P: 0.532) and duration of hospital stay (P: 0.138) in 72 h. The technical success of both procedures was 100%. While 20 out of 22 patients with PA were having a noticable recovery, only one was treated with twice PA procedures and a complete recovery was observed (4.5%). Complication rates were low in both groups and were statistically insignificant (P: 1.00).

Conclusion: In this pandemic period, PA and PC procedures are effective, reliable, and successful treatment method that can be applied at the bedside for critical patients with AC who are not compatible with surgery, which are safe for health workers and low-risk minimal invasive procedures for patients. In uncomplicated AC patients, PA should be performed, and if there is no response to treatment, PC should be reserved as a salvage procedure. The PC procedure should be performed in patients with AC who have developed complications and are not suitable for surgery.

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来源期刊
CiteScore
1.40
自引率
18.20%
发文量
82
审稿时长
4-8 weeks
期刊介绍: The Turkish Journal of Trauma and Emergency Surgery (TJTES) is an official publication of the Turkish Association of Trauma and Emergency Surgery. It is a double-blind and peer-reviewed periodical that considers for publication clinical and experimental studies, case reports, technical contributions, and letters to the editor. Scope of the journal covers the trauma and emergency surgery. Each submission will be reviewed by at least two external, independent peer reviewers who are experts in their fields in order to ensure an unbiased evaluation process. The editorial board will invite an external and independent reviewer to manage the evaluation processes of manuscripts submitted by editors or by the editorial board members of the journal. The Editor in Chief is the final authority in the decision-making process for all submissions.
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