|
|
|
题名
|
作者
|
年代
|
出处
|
被引量
|
| 1 | Biliary stenting with or without sphincterotomy for malignant biliary obstruction:A meta-analysis显示文摘AIM:To investigate the benefits of endoscopic sphincterotomy(EST) before stent placement by meta-analysis of randomized controlled trials(RCTs). METHODS:PubMed,EMBASE,Cochrane Library,and Science Citation Index databases up to March 2014 were searched. The primary outcome was incidence of post-endoscopic retrograde cholangiopancreatography(ERCP) pancreatitis(PEP) and successful stent insertion rate. The secondary outcomes were the incidence of post-ERCP bleeding,stent migration and occlusion. The free software Review Manager was used to perform the meta-analysis.RESULTS:Three studies(n=338 patients,170 in the EST group and 168 in the non-EST group)were included.All three studies described a comparison of baseline patient characteristics and showed that there were no statistically significant differences between the two groups.Three RCTs,including 338 patients,were included in this meta-analysis.Most of the analyzed outcomes were similar between the groups.Although EST reduced the incidence of PEP,it also led to a higher incidence of post-ERCP bleeding(OR=0.34,95%CI:0.12-0.93,P=0.04;OR=9.70,95%CI:1.21-77.75,P=0.03,respectively).CONCLUSION:EST before stent placement may be useful in reducing the incidence of PEP.However,ESTrelated complications,such as bleeding and perforation,may offset this effect. | Pei-Jing Cui Jing Yao Yi-Jun Zhao Hua-Zhong Han Jun Yang | 2014 | World Journal of Gastroenterology2014，20，38： | 9 |
| 2 | 内镜下十二指肠乳头括约肌小切开联合气囊扩张术治疗胆总管结石的价值显示文摘十二指肠镜下行十二指肠乳头括约肌切开术(EST)或气囊扩张术(EPBD)治疗肝外胆管结石,由于其微创性、安全性、有效性以及并发症少等优势,得到了人们的广泛认可。但是 EST 治疗胆总管结石所引起的并发症,如出血、穿孔、胰腺炎、胆管炎和十二指肠乳头括约肌受损导致的反流性胆管炎和结石复发等,发病率仍较高。而 EPBD 虽可以保护十二指肠乳头括约肌功能,具有较高的取石成功率,术后并发症如出血、穿孔等亦较 EST 少,但因气囊压迫胰管开口,术后急性胰腺炎的发生率相对较高[1],使其应用受到一定限制。如何在胆总管结石内镜取石中取得更好的疗效,并减少术后并发症已经成为广大临床工作者的研究重点。本文采用内镜下乳头括约肌小切开联合 EPBD 治疗胆总管结石,旨在探讨该方法的应用价值。 | 薛冬云 王玲 曲少贤 王娟 | 2014 | 国际消化病杂志2014，34，6： | 9 |
| 3 | Efficacy and safety of limited endoscopic sphincterotomy before self-expandable metal stent insertion for malignant biliary obstruction显示文摘AIM To evaluate the safety and efficacy of limited endoscopic sphincterotomy (ES) before placement of selfexpandable metal stent(SEMS).METHODS This was a retrospective analysis of 244 consecutive patients with unresectable malignant biliary obstruction, who underwent placement of SEMSs following limited ES from December 2008 to February 2015. The diagnosis of malignant biliary obstruction and assessment of patient eligibility for the study was established by a combination of clinical findings, laboratory investigations, imaging and pathological results. All patients were monitored in the hospital for at least 24 h following endoscopic retrograde cholangio pancreatography(ERCP). The incidence of immediate or early post-ERCP complications such as post-ERCP pancreatitis(PEP) and bleeding related to limited ES were considered as primary outcomes. Also, characteristics and complications according to the cancer type were classified.RESULTS Among the 244 patients included, the underlying diagnosis was cholangiocarcinoma in 118 patients,pancreatic cancer in 79, and non-pancreatic or nonbiliary malignancies in the remaining 47 patients. Early post-ERCP complications occurred in 9 patients(3.7%), with PEP in 7 patients (2.9%; mild, 6; moderate, 1) and mild bleeding in 2 patients (0.8%). There was no significant association between the incidence of post-ERCP complications and the type of malignancy(cholangiocarcinoma vs pancreatic cancer vs others, P = 0.696) or the type of SEMS used (uncovered vs covered, P = 1.000). Patients who had more than one SEMS placed at the first instance were at a significantly higher risk of post-ERCP complications (one SEMS vs two SEMS, P = 0.031). No other factors were predictive of post-ERCP complications.CONCLUSION Limited ES is feasible and safe, and effectively facilitates the placement of SEMS, without any significant risk of PEP or severe bleeding. | Hyeong Seok Nam Dae Hwan Kang Hyung Wook Kim Cheol Woong Choi Su Bum Park Su Jin Kim Dae Gon Ryu | 2017 | World Journal of Gastroenterology2017，23，9： | 7 |
| 4 | 内镜逆行胰胆管造影术后胰腺炎的危险因素及其预防显示文摘随着ERCP及相关技术广泛用于胆胰疾病的诊治,其并发症的防治日益受到重视。急性胰腺炎是最常见且严重的内镜逆行胰胆管造影(endoscopic retrograde cholangiopancreatography,ERCP)术后并发症,且ERCP术后胰腺炎的预测是困难的。本文就ERCP术后胰腺炎(post—ERCP—pancreati—tis,PEP)的危险因素、发生机理及预防做一综述,旨在提高ERCP诊治水平并预防ERCP术后胰腺炎发生。 | 雷春 朱虹 | 2016 | 肝胆外科杂志2016，24，4： | 7 |
| 5 | ERCP联合EST治疗与患者术后发生急性胰腺炎关系的Meta分析显示文摘目的探讨实施内镜逆行胰胆管造影术联合乳头括约肌切开术治疗与患者发生术后胰腺炎的关系。方法全面检索2013年7月以前公开发表的实施内镜逆行胰胆管造影术联合乳头括约肌切开术治疗与患者发生术后胰腺炎关系的文献,采用RevMan 5.1.4版本软件对文献数据进行综合分析。结果检索并纳入关于实施内镜逆行胰胆管造影术联合乳头括约肌切开术治疗与患者发生术后胰腺炎关系的文献共11篇,患者共3 294例,其中单纯内镜逆行胰胆管造影术组患者2 181例,内镜逆行胰胆管造影术联合乳头括约肌切开术组患者1 113例。实施内镜逆行胰胆管造影术联合乳头括约肌切开术治疗与单纯实施内镜逆行胰胆管造影术检查患者术后胰腺炎发生率的合并优势比为2.27[95%可信区间(1.11,4.65)],P=0.03,差异有统计学意义。结论对患者实施内镜逆行胰胆管造影术联合乳头括约肌切开术治疗与单纯实施内镜逆行胰胆管造影术检查相比,前者术后发生术后胰腺炎的几率明显增大,应引起临床医师的重视。 | 尹延伟 张金泉 孙倩倩 胡爱民 刘宏利 王琦 | 2014 | 循证医学2014，14，1： | 6 |
| 6 | 急性胆管炎患者胆汁病原菌分布与药敏性分析显示文摘目的了解急性胆管炎患者胆汁病原菌分布及药敏性,为正确选择抗菌药物治疗提供依据。方法选取2009年6月-2015年6月于医院治疗的急性胆管炎患者145例,采集患者胆汁标本采用WITEK-2Compact进行菌种鉴定,药敏试验采用K-B纸片扩散法进行,数据采用SPSS15.0进行统计分析。结果 145例患者共送检胆汁标本195份,培养出病原菌158株,其中革兰阳性菌58株占36.71%,革兰阴性菌95株占60.13%,真菌5株占3.16%;革兰阳性菌对替考拉宁、亚胺培南、万古霉素的敏感性较高均在75.00%以上,对青霉素G、阿奇霉素、氧氟沙星的敏感性低;革兰阴性菌对哌拉西林、美罗培南、亚胺培南、阿米卡星敏感性高均在75.00%以上,对氨苄西林、头孢噻肟、氨曲南敏感性低;真菌对酮康唑、氟康唑、伊曲康唑及伏立康唑的敏感性均为100.00%。结论急性胆管炎患者感染的主要病原菌是革兰阴性菌,革兰阳性菌和革兰阴性菌对常用抗菌药的敏感性有一定程度的下降,临床应根据药敏试验结果选用合理的抗菌药物。 | 延学军 岳风芝 赵付生 刘洪锋 刘耿 | 2016 | 中华医院感染学杂志2016，26，6： | 5 |
| 7 | 括约肌切开对于经内镜胆道支架引流术作用的Meta分析显示文摘目的探讨内镜下放置胆道支架解除恶性胆管梗阻时,预先实施括约肌切开的价值。方法检索各主要中英文医学文献数据库,收集所有有关联合括约肌切开和胆道支架引流与单纯支架置人的对照研究。采用RevMan5.3.4统计软件进行Meta分析。结果共纳入4项符合标准的研究,共计428例患者,十二指肠乳头切开组(EST组)214例、未切开组(NEST组)214例。与NEST组相比,EST组在支架放置成功率、术后胆管炎、支架移位率、支架阻塞率等方面差异并无统计学意义,术后乳头部出血发生率明显增加(P=0.002),术后胰腺炎发生率减少(P=0.04)。结论内镜下放置胆道支架前行括约肌切开可减少术后胰腺炎的发生,但相应的术后出血风险将减少其可能的获益。 | 胡贤荣 沈艺南 李冰 薄志远 万伟 吴军 高道键 王田田 叶馨 胡冰 | 2015 | 中华消化内镜杂志2015，32，8： | 1 |
| 8 | 105例老年急性胆道感染患者的外科治疗显示文摘目的探讨老年急性胆道感染患者急诊外科治疗方法及疗效。方法回顾性分析2001年1月至2011年12月我院105例因急性胆道感染进行急诊手术老年患者的临床资料,其中男42例,女63例,年龄70~86岁。单纯急性胆囊炎、胆囊结石46例,合并胆管结石梗阻性胆管炎59例,有手术史或合并症的74例。入院后24 h内手术者24例,入院后经24~72 h保守治疗无效后改为急诊手术者81例。结果全部患者均选择使用头孢类、喹诺酮类、氨基糖苷类和甲硝唑等抗生素抗感染,同时加强对原发基础病及并发症的治疗。105例中72例(68.57%)治愈出院,术后并发症31例(29.52%),死亡2例(1.90%)。结论老年患者急性胆道感染病情发展快,并发症多,根据病情积极采用个体化治疗可以防止术后并发症和降低死亡率。 | 叶诚清 陈松 谢凯 | 2013 | 局解手术学杂志2013，22，3： | 1 |
您所在的机构暂未开通此部分的功能，请联系管理员