内視鏡的胆道ドレナージ

英
endoscopic biliary drainage EBD
関
内視鏡的逆行性膵胆管造影法 endoscopic retrograde biliary drainage ERBD
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概念

(医学辞書より)
  • 内視鏡により十二指腸乳頭を経由して胆管ドレナージチューブを挿入すること。
  • 歴史的には、内視鏡的乳頭切開術が開発された後、その合併症として起こる胆管結石の嵌頓による急性胆管炎の治療法として1980年に考案された。

参考

  • Endoscopic Biliary Drainage for Severe Acute Cholangitis
  • Edward C.S. Lai, F.R.C.S.(Ed.), F.R.A.C.S., Francis P.T. Mok, F.R.C.S.(Ed.), F.R.A.C.S., Eliza S.Y. Tan, R.N., Chung-mau Lo, F.R.C.S.(Ed.), Sheung-tat Fan, F.R.C.S.(Glas.), Kok-tjang You, M.D., and John Wong, Ph.D., F.R.A.C.S., F.R.C.S.(Ed.)
  • N Engl J Med 1992; 326:1582-1586June 11, 1992
Background.: Emergency surgery for patients with severe acute cholangitis due to choledocholithiasis is associated with substantial morbidity and mortality. Because recent results suggested that emergency endoscopic drainage could improve the outcome of such patients, we undertook a prospective study to determine the role of this procedure as initial treatment.
Results: Complications related to biliary tract decompression and subsequent definitive treatment developed in 14 patients treated with endoscopic biliary drainage and 27 treated with surgery (34 vs. 66 percent, P>0.05). The time required for normalization of temperature and stabilization of blood pressure was similar in the two groups, but more patients in the surgery group required ventilatory support. The hospital mortality rate was significantly lower for the patients who underwent endoscopy (4 deaths) than for those treated surgically (13 deaths) (10 vs. 32 percent, P<0.03). The presence of concomitant medical problems, a low platelet count, a high serum urea nitrogen concentration, and a low serum albumin concentration before biliary decompression were the other independent determinants of mortality in both groups.

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