Objective To access the therapeutic efficacy of newly-designed digital cholangioscope-assisted bedside one-stage lithotomy and biliary drainage for severe acute cholangitis caused by choledocholithiasis.Methods Data o...Objective To access the therapeutic efficacy of newly-designed digital cholangioscope-assisted bedside one-stage lithotomy and biliary drainage for severe acute cholangitis caused by choledocholithiasis.Methods Data of 26 patients were retrospectively analyzed,who were admitted into the intensive care unit(ICU),Zhongda Hospital,Southeast University,due to choledocholithiasis induced by severe acute cholangitis and underwent cholangioscope-assisted bedside one-stage lithotomy and biliary drainage from June 2020 to February 2022.Clinical outcomes were analyzed.Results The time interval from disease onset to endoscopic intervention was 36.2±15.5 hours,with 7.2±4.9 hours from ICU admission to endoscopic intervention.Technical success rate was 100.0%in one-stage stone removal and biliary drainage.Except for one mild pancreatitis,no other complications occurred.Acute physiology and chronic health evaluation(APACHE)II and sequential organ failure assessment(SOFAs)cores prior to endoscopic intervention were 25.2±6.6 and 11.9±3.5,respectively.APACHE II scores at day 1,3,and 7 after endoscopic intervention were 21.7±6.5,17.2±6.8 and 12.7±7.7,respectively,and SOFA scores were 10.6±2.9,8.4±3.0 and 5.4±3.7,respectively,all of which were lower than those before operation(P<0.001).The length of ICU stay and total hospitalization was 9.7±5.0 days and 12.8±4.5 days,respectively.In-hospital mortality occurred in 3(11.5%)patients.According to a 6-month follow-up,one patient died of pneumonia,and another died of acute myocardial infarction.No acute cholangitis re-occurred in those survivors.Conclusion Newly-designed digital cholangioscope-assisted bedside one-stage lithotomy and biliary drainage demonstrate significant improvements in prognosis,highlighting its safety in managingsevere acute cholangitis.展开更多
文摘Objective To access the therapeutic efficacy of newly-designed digital cholangioscope-assisted bedside one-stage lithotomy and biliary drainage for severe acute cholangitis caused by choledocholithiasis.Methods Data of 26 patients were retrospectively analyzed,who were admitted into the intensive care unit(ICU),Zhongda Hospital,Southeast University,due to choledocholithiasis induced by severe acute cholangitis and underwent cholangioscope-assisted bedside one-stage lithotomy and biliary drainage from June 2020 to February 2022.Clinical outcomes were analyzed.Results The time interval from disease onset to endoscopic intervention was 36.2±15.5 hours,with 7.2±4.9 hours from ICU admission to endoscopic intervention.Technical success rate was 100.0%in one-stage stone removal and biliary drainage.Except for one mild pancreatitis,no other complications occurred.Acute physiology and chronic health evaluation(APACHE)II and sequential organ failure assessment(SOFAs)cores prior to endoscopic intervention were 25.2±6.6 and 11.9±3.5,respectively.APACHE II scores at day 1,3,and 7 after endoscopic intervention were 21.7±6.5,17.2±6.8 and 12.7±7.7,respectively,and SOFA scores were 10.6±2.9,8.4±3.0 and 5.4±3.7,respectively,all of which were lower than those before operation(P<0.001).The length of ICU stay and total hospitalization was 9.7±5.0 days and 12.8±4.5 days,respectively.In-hospital mortality occurred in 3(11.5%)patients.According to a 6-month follow-up,one patient died of pneumonia,and another died of acute myocardial infarction.No acute cholangitis re-occurred in those survivors.Conclusion Newly-designed digital cholangioscope-assisted bedside one-stage lithotomy and biliary drainage demonstrate significant improvements in prognosis,highlighting its safety in managingsevere acute cholangitis.
