Sphincterotomy during endoscopic biliary drainage in cholangitis with sepsis-induced coagulopathy increases bleeding without clinical benefits.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Hiroshima Yasuhisa, Sagami Ryota, Kuraoka Naosuke, Noguchi Tatsuya, Matsuda Yasusato, Terayama Takero, Azuma Yoshifumi, Sato Takao, Nishikori Hidefumi, Honda Hideho, Goto Yasuhiko, Noguchi Haruna, Fukuchi Satoshi, Omori Kaoru, Motomura Mitsuteru, Okimoto Tadayoshi, Okamoto Kazuhisa, Mori Hideki, Sato Tatsuya, Takahashi Kosuke, Ozawa Eisuke, Ikeda Eriko, Kanno Atsushi, Komoto Shunsuke, Koga Takehiko, Ishida Yusuke, Kobayashi Kiyoyuki, Hinokuchi Makoto, Ihara Ryo, Ueda Takahiro, Fujimori Nao, Matsunari Osamu, Noguchi Chishio, Mizukami Kazuhiro, Murakami Kazunari
Аннотация
AIMS: To evaluate the risk of adverse events (AEs) and clinical outcomes associated with EBD with or without EST in patients with AC and SIC.
METHODS: In this retrospective multicentre cohort study, data from enrolled patients were analysed using propensity score matching, and outcomes were compared between EST and non-EST groups. The primary endpoint was the AE rate difference between EBD with and without EST. Secondary endpoints included differences in clinical outcomes.
RESULTS: Among 238 patients, 72 underwent EST and 166 did not. The AE incidence, particularly bleeding-related (11.1% vs. 0.6%, P<.001), was higher in the EST group (16.7% vs. 1.8%, P<.001) while PEP incidence (4.2% vs. 1.2%, P=.143) did not differ. Propensity score-matched analysis confirmed these findings. Clinical success or 28-day survival rates did not differ significantly.
CONCLUSION: EST significantly increases bleeding risk in patients with AC and SIC without reducing PEP incidence or improving clinical outcomes. EBD without EST can minimise bleeding risk while maintaining adequate biliary drainage.