Nisan 2010
Malign bilier obstrüksiyonlarda ve eslik eden bilomalarda perkütan bilier drenaj
Percutaneous biliary drainage in malignant biliary obstruction and accompanying bilomas
- Ana Sayfa
- Sayılar
- Nisan 2010
- Malign bilier obstrüksiyonlarda ve eslik eden bilomalarda perkütan bilier drenaj...
Özet
Amaç: Bu çalismanin amaci, malign bilier obstrüksiyonlarda ve eslik eden patolojilerinde yapilan palyatif amaçli perkütan bilier drenajin etkinligi ve komplikasyonlari ile birlikte sonuçlarini tartismaktir. Gereç ve Yöntem: Ocak 1998 - Temmuz 2008 döneminde malign obstrüksiyonlu, 47'si erkek, 29'u kadin, 76 olguda perkütan bilier drenaj gerçeklestirildi. Olgularin yaslari 29 ile 80 arasinda (ortalama yas: 54.8±11.9) degismekte idi. Hemen tüm hastalarda klinik yakinma olarak ikter olmakla birlikte bir kisminda eslik eden agri, bulanti, kusma, kasinti, halsizlik, kilo kaybi mevcuttu. 5 olguda (%6.6) bilier stent takildi. Olgulardan üçünde (%4.0) biloma mevcuttu. Basari islem öncesi ve islem sonrasi bilirubin (totaldirekt) takibi ve klinik düzelme referans alinarak degerlendirildi. Bu bilirubin degerleri, istatistiksel olarak Wilcoxon signed ranks test ile karsilastirildi. Bulgular: 70 olguda basari saglandi. Direk bilirubin islem öncesi ortalama 14.2±7.4 mg/dl (3.0-36.0) iken, islem sonrasi 7.1±5.5 mg/dl (0.2-20.0) idi. Olgularin bilirubin degerleri belirgin olarak azaldi (p<0.001). Hastalar 2 gün ile 4 yil arasinda takip edildiler (ortalama takip süresi 83 gün). Sepsis gelisen iki olguda (%2.6) islem basarisizdi. Malign bilier drenajda %97.4 ve eslik eden bilomalarin tümünde teknik basari saglandi. Sonuç: Perkütan bilier drenaj, malign bilier obstrüksiyonlu olgularin palyasyonunda, enfeksiyon ve biloma gibi eslik eden patolojilerinde etkin girisimsel radyolojik bir yöntemdir.
Abstract
Background and Aims: The purpose of this study was to discuss the results together with efficacy and complications of palliative percutaneous biliary drainage in cases with malignant biliary obstructive jaundice and accompanying pathologies. Materials and Methods: During the period January 1998-July 2008, percutaneous biliary drainage was performed in 76 patients (47 males, and 29 females) with malignant biliary obstruction. Ages ranged between 29 and 80 years (mean: 54.8±11.9 years). Many patients had pain, emesis, vomiting, itching, weakness, and weight loss, while jaundice was the clinical symptom in almost all. Biliary stent was placed in 5 (6.6%). Biloma was seen in 3 (4.0%). Success was evaluated by referencing direct bilirubin levels before and after drainage and clinical recovery. These bilirubin levels were statistically compared via Wilcoxon signed ranks test. Results: Drainage was successful in 70 patients. Mean bilirubin was 14.2±7.4 mg/dl (3.0-36.0) before drainage and 7.1±5.5 mg/dl (0.2-20.0) after drainage. Bilirubin levels decreased significantly (p<0.001). Patients were followed between 2 days and 4 years (mean: 83 days). The procedure failed in 2 (2.6%) patients with septicemia. Technique success was seen in 97.4% of malignant biliary drainages and all bilomas. Conclusions: Percutaneous biliary drainage is an effective interventional radiological method in palliation therapy of malignant biliary obstruction and associated pathologies as infection and biloma.
