Aralik 2010
Endosonografinin etkin kullaniminin gastroenteroloji günlük tibbi pratigine etkileri
The effects of efficient usage of endosonography in the daily medical practice of gastroenterology
- Ana Sayfa
- Sayılar
- Aralik 2010
- Endosonografinin etkin kullaniminin gastroenteroloji günlük tibbi pratigine etkileri...
Ege Üniversitesi Tip Fakültesi, 4Anestezi ve Reanimasyon Bilim Dali, Izmir
Özet
Giris ve Amaç: Endosonografinin etkin kullaniminin gastroenteroloji günlük pratigine etkilerini degerlendirmeyi amaçladik. Gereç ve Yöntem: Çalismamiz, tersiyer bir hastanede retrospektif olarak yapildi. Haziran 2007Haziran 2008 (Dönem 1) ve Haziran 2009Haziran 2010 (Dönem 2) arasinda hasta demografikleri, tanilari, yatis gün sayisi, endoskopik retrograd kolanjiyopankreatografi islemi, radyolojik tani yöntemleri kullanilan hastalara ait veriler degerlendirildi. Dönemlere göre; terapötik endoskopik retrograd kolanjiyopankreatografi oranlari, manyetik rezonans kolanjiyopankreatografi ile safra yolu degerlendirme oranlari, pankreas kitlelerinden sitolojik örnekleme oranlari, kronik pankreatit tani oranlari, akut biliyer pankreatitli hastalarda hastane yatis süreleri karsilastirildi. Bulgular: Dönem 1?de 187, dönem 2?de 2027 endosonografi islemi yapildi. Terapötik endoskopik retrograd kolanjiyopankreatografi orani Dönem 1 ve 2?de sirasiyla %71,3 ve %90,7; manyetik rezonans kolanjiyopankreatografi gereken hasta sayisi 617 ve 29 idi. Dönem 1?de 81 hastanin 24?ünde transabdominal ultrasonografi ile biyopsi alindi, Dönem 2?de 187 hastanin 155?inde lineer endosonografi ile doku örneklemesi yapildi. Yeni tani konulan kronik pankreatitli hasta sayisi Dönem 1 ve 2?de sirasiyla 8 ve 51 hasta; akut biliyer pankreatitli hastalarin ortalama yatis günü 11,6 ± 5,4 gün ve 7,8 ± 4,5 gün idi. Sonuç: Bu çalismada, endosonografinin etkin kullaniminin terapötik endoskopik retrograd kolanjiyopankreatografi oranini, kronik pankreatit tani koyma oranini, pankreatik kitlelerde doku tanisi koyma oranini arttirdigini, endoskopik retrograd kolanjiyopankreatografi randevu gününü ve akut biliyer pankreatitli hastalarda yatis süresini kisalttigini saptadik. Etkin endosonografi kullanimi için, bir hekimin sadece endosonografi ile ilgilenmesi ve endosonografi tecrübesini arttirmasi gerektigini düsünmekteyiz.
Abstract
Background and Aims: Our aim was to evaluate the efficient use of endosonography in the daily practice of gastroenterology. Material and Methods: Our study was done retrospectively in a tertiary hospital. Data including patient demographics, diagnosis, duration of hospital stay, endoscopic retrograde cholangiopancreatography procedure, and radiologic diagnostic tests were evaluated between June 2008 and June 2009 (Period 1) and between June 2009 and June 2010 (Period 2). Therapeutic endoscopic retrograde cholangiopancreatography rates, biliary tract evaluation rates with magnetic resonance cholangiopancreatography, cytologic sampling rates from pancreatic masses, diagnostic rates of chronic pancreatitis, and duration of hospital stay of acute biliary pancreatitis patients were compared between the two periods. Results: Endoscopic ultrasound was performed in 187 and 2027 patients in Periods 1 and 2, respectively. The ratios of therapeutic endoscopic retrograde cholangiopancreatography were 71.3% and 90.7% and the numbers of patients requiring magnetic resonance cholangiopancreatography were 617 and 29 in Periods 1 and 2, respectively. Biopsy was conducted with transabdominal US in 24 of 81 patients in Period 1; tissue sampling was done with linear endosonography in 155 of 187 patients in Period 2. The numbers of patients with recently diagnosed chronic pancreatitis in Periods 1 and 2 were 8 and 51, respectively; the mean hospital stays of acute biliary pancreatitis patients were 11.6 ± 5.4 and 7.8 ± 4.5 days, respectively. Conclusions: In this study, we determined that the efficient use of endosonography increases the therapeutic endoscopic retrograde cholangiopancreatography rates, the diagnostic rates of chronic pancreatitis patients and the tissue diagnostic rates of pancreatic masses; it also diminishes the endoscopic retrograde cholangiopancreatography appointment time and the hospitalization duration of acute biliary pancreatitis patients. We believe that endosonography should be the responsibility of only one physician in a clinic in order to increase their experience.
