Endosonography and magnetic resonance cholangiopancreatography show similar efficacy in selecting patients for ERCP in mild-moderate acute biliary pancreatitis
Küçük Resim Yok
Tarih
2012
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Hafif-orta şiddette akut biliyer pankreatitli hastalarda endoskopik retrograd kolanjiyopankreatografi gereksinimini belirlemede endosonografi ve manyetik rezonans kolanjiyopankreatografinin değerlerini karşılaştırmayı amaçladık. Metod: Çalışma üçüncü basamak bir hastanede Haziran 2006 ile Ekim 2009 arasında prospektif olarak yürütülmüştür. Acil endoskopik retrograd kolanjiyopankreatografi gereksinimi olmayan hafif-orta şiddette akut biliyer pankreatitli 95 hasta çalışmaya alınmıştır. Beşinci günde amilaz, C-reaktif protein ve bilirubin değerleri başvuru değerlerine göre %50’den daha fazla düşen hastalar manyetik rezonans kolanjiyopankreatografi veya endosonografi gruplarına randomize edilmişlerdir ve ana safra kanalı değerlendirilmiştir. Endoskopik retrograd kolanjiyopankreatografi, endosonografi veya manyetik rezonans kolanjiyopankreatografi ile taş tespit edilenlerde yapılmıştır. Endoskopik retrograd kolanjiyopankreatografideki taş varlığına göre endoskopik retrograd kolanjiyopankreatografi işlemleri tedavi ya da tanısal amaçlı olarak sınışandırılmıştır. Bulgular: Endosonografi grubundaki 48 hastanın 16’sına (%33) ve manyetik rezonans kolanjiyopankreatografi grubundaki 47 hastanın 18’ine (%38) endoskopik retrograd kolanjiyopankreatografi yapılmıştır. Terapötik endoskopik retrograd kolanjiyopankreatografi oranı, endosonografi grubunda (14/16) (87%), manyetik rezonans kolanjiyopankreatografi grubundakinden (16/18) (88%), istatistiksel olarak farklı değildi. Toplam endoskopik retrograd kolanjiyopankreatografi sayısı oranları da endosonografi grubunda (16/48) ve manyetik rezonans kolanjiyopankreatografi grubunda (18/47) benzer bulundu. Sonuç: Hafif-orta şiddette akut biliyer pankreatitte terapötik endoskopik retrograd kolanjiyopankreatografi gerekliliği endosonografi ve manyetik rezonans kolanjiyopankreatografi ile benzer etkinlikte saptanabilmektedir.
Background/aims: We aimed to compare the value of endoscopic ultrasonography and magnetic resonance cholangiopancreatography in identifying the patients with mild-moderate acute biliary pancreatitis who require endoscopic retrograde cholangiopancreatography. Material and Methods: The study was prospectively conducted in a tertiary hospital between June 2006 and October 2009. Ninety-five patients without urgent endoscopic retrograde cholangiopancreatography requirement and with mild-moderate acute biliary pancreatitis were included in the study. Patients whose amylase, C-reactive protein, and bilirubin levels had decreased more than 50% on the fifth day compared to admission levels were randomized to magnetic resonance cholangiopancreatography or endoscopic ultrasonography, and the common bile duct was evaluated. Endoscopic retrograde cholangiopancreatography was performed in patients with stone detected with endoscopic ultrasonography or magnetic resonance cholangiopancreatography. With regard to the presence of common bile duct stone in endoscopic retrograde cholangiopancreatography, endoscopic retrograde cholangiopancreatography performances were classified as therapeutic or diagnostic. Results: Endoscopic retrograde cholangiopancreatography was performed in 16 of the 48 patients (33.3%) in the endoscopic ultrasonography group and in 18 of the 47 patients (38%) in the magnetic resonance cholangiopancreatography group. Therapeutic endoscopic retrograde cholangiopancreatography was performed in 14/16 patients (87%) in the endoscopic ultrasonography group and in 16/18 patients (88%) in the magnetic resonance cholangiopancreatography group. The ratio of total number of endoscopic retrograde cholangiopancreatographis was not significantly lower in the endoscopic ultrasonography (16/48) than in the magnetic resonance cholangiopancreatography (18/47) group, and the ratio of therapeutic endoscopic retrograde cholangiopancreatographis (14/16) was not higher in the endoscopic ultrasonography group than in the magnetic resonance cholangiopancreatography group (16/18). Conclusions: The necessity of therapeutic endoscopic retrograde cholangiopancreatography was determined with similar efficacy by endoscopic ultrasonography and magnetic resonance cholangiopancreatography in mild-moderate acute biliary pancreatitis.
Background/aims: We aimed to compare the value of endoscopic ultrasonography and magnetic resonance cholangiopancreatography in identifying the patients with mild-moderate acute biliary pancreatitis who require endoscopic retrograde cholangiopancreatography. Material and Methods: The study was prospectively conducted in a tertiary hospital between June 2006 and October 2009. Ninety-five patients without urgent endoscopic retrograde cholangiopancreatography requirement and with mild-moderate acute biliary pancreatitis were included in the study. Patients whose amylase, C-reactive protein, and bilirubin levels had decreased more than 50% on the fifth day compared to admission levels were randomized to magnetic resonance cholangiopancreatography or endoscopic ultrasonography, and the common bile duct was evaluated. Endoscopic retrograde cholangiopancreatography was performed in patients with stone detected with endoscopic ultrasonography or magnetic resonance cholangiopancreatography. With regard to the presence of common bile duct stone in endoscopic retrograde cholangiopancreatography, endoscopic retrograde cholangiopancreatography performances were classified as therapeutic or diagnostic. Results: Endoscopic retrograde cholangiopancreatography was performed in 16 of the 48 patients (33.3%) in the endoscopic ultrasonography group and in 18 of the 47 patients (38%) in the magnetic resonance cholangiopancreatography group. Therapeutic endoscopic retrograde cholangiopancreatography was performed in 14/16 patients (87%) in the endoscopic ultrasonography group and in 16/18 patients (88%) in the magnetic resonance cholangiopancreatography group. The ratio of total number of endoscopic retrograde cholangiopancreatographis was not significantly lower in the endoscopic ultrasonography (16/48) than in the magnetic resonance cholangiopancreatography (18/47) group, and the ratio of therapeutic endoscopic retrograde cholangiopancreatographis (14/16) was not higher in the endoscopic ultrasonography group than in the magnetic resonance cholangiopancreatography group (16/18). Conclusions: The necessity of therapeutic endoscopic retrograde cholangiopancreatography was determined with similar efficacy by endoscopic ultrasonography and magnetic resonance cholangiopancreatography in mild-moderate acute biliary pancreatitis.
Açıklama
Anahtar Kelimeler
Cerrahi
Kaynak
Turkish Journal of Gastroenterology
WoS Q Değeri
Scopus Q Değeri
Cilt
23
Sayı
5
