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題名 | Endoscopic Nasobiliary Drainage in Acute Biliary Pancreatitis-A Preliminary Experience=經內視鏡鼻膽管引流術治療急性膽道性胰臟炎之初步經驗 |
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作者姓名(中文) | 蔡青陽; 羅海韻; 張維興; 阮仲垠; | 書刊名 | 中華民國消化系醫學雜誌 |
卷期 | 14:1 1997.03[民86.03] |
頁次 | 頁1-6 |
分類號 | 415.542 |
關鍵詞 | 經內視鏡鼻膽管引流術; 急性膽道性胰臟炎; Endoscopic nasobiliary drainage; Acute biliary pancreatitis; |
語文 | 英文(English) |
中文摘要 | 「經內視鏡鼻膽管引流術」為治療膽道阻塞性疾病的有效且安全之方法之一,雖 然急性膽道性胰臟炎可以經內視鏡括約肌切開術來治療,但由於有危險性及併發症,故我們 嘗試以內視鏡鼻膽管引流術來治療急性膽道性胰臟炎並觀察其成效。 自 1995 年 12 月至 1996 年 7 月,共有 23 個急性膽道性胰臟炎病例接受經內視鏡鼻膽管引流術治療,其中男 性 9 例,女性 14 例,平均年齡 46.5 歲。 所有病患均經臨床症狀,實驗室檢查,腹部超 音波及經內視鏡逆行性膽胰管攝影術檢查証實,而於住院 48 小時內接受緊急經內視鏡鼻膽 管引流術治療,按總膽管結石之存在與否,細分為兩組,結果發現兩組經內視鏡鼻膽管引流 之成功率均為 100 %,於治療後第一、二、三天腹痛消失者,分別為 13 例 (56.5 % ), 8 例 (34.8 % ) 及 2 例 (8.7 % )。實驗室檢查之異常數據於 5.2 天內恢復正常。兩組 之生化異常恢復正常所需間及併發症發生率並無統計學之差別。本研究中並無任何併發症發 生, 於臨床症狀改善後,19 例病人接受例行手術摘除膽囊或截取膽管結石,4 例接受內科 保守療法,平均住院日數 9.7 天。 對於高齡危險群病患及其他不適於施行經內視鏡括約肌 切開術或開刀之患者而言,經內視鏡鼻膽管引流術是治療急性膽道性胰臟炎之另一種技術, 但仍需以對照實驗來証實它的實用價值。 |
英文摘要 | Endoscopic sphincterotomy (EST) for treating acute biliary pancreatitis (ABP) has been widely accepted. However, EST may cause some severe complications such as bleeding and perforation. Endoscopic nasobiliary drainage (ENBD) is an effective and safe method in treating obstructive biliary tract disease. In this study we used ENBD to relieve ampullary obstruction in ABP and assessed its effectiveness. From December 1995 to July 1996, 23 patients (9 males, 14 females, mean age: 46.5 years) with ABP received ENBD treatment. All patients received ENBD treatment within 48 hours of admission. Patients were further classified into two groups according to the existence of common bile duct stones. The success rate of ENBD in both groups was 100%. Abdominal pain disappeared in 13 cases (56.6%), 8 cases (34.8%) and 2 cases (8.7%) on the 1st, 2nd and 3rd day after admission respectively. laboratory data normalized within an average of 5.2 days. No complication occurred in this study. There was no statistical difference in these two groups in the time required for normalization of biochemical tests and complication rate. After clinical improvement, 19 patients received surgical operation and the remaining 4 patients received conservative treatment only. The mean length of hospitalization was 9.7 days. In high-risk, aged patients or patients contraindicated for operation and EST, ENBD is a safe, alternative procedure and worthy to be applied clinically in treating patients with ABP. Further randomized, controlled study in comparing ENBD with EST or conservative treatment for patients with ABP is needed. |
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