Nisan 2025
Tasli hafif akut kolanjit hastalarinda ERCP zamaninin hastanede yatis süresine etkisi
Effect of ERCP timing on length of hospitalization in patients with mild acutecholangitis with calculi
- Ana Sayfa
- Sayılar
- Nisan 2025
- Tasli hafif akut kolanjit hastalarinda ERCP zamaninin hastanede yatis süresine etkisi...
Özet
Giris ve Amaç:Günümüzde, orta ve siddetli akut kolanjitte erken endoskopik retrograd kolanjiopankreatogra? önerilmekte iken, ha?fakut kolanjitte endoskopik retrograd kolanjiopankreatogra? için en uygun zamanlama konusu tartismalidir. Çalismamizda, akut kolanjitin en yaygin nedeni olan ha?f tasli akut kolanjitte endoskopik retrograd kolanjiopankreatogra? zamaninin hastanede yatis süresi üzerindeki etkisini inceledik.Ayrica, uzun süreli hastane yatisini öngören faktörleri arastirdik.Gereç ve Yöntem:Çalisma, Subat 2019 ile Nisan 2021 tarihleri arasinda ha?ftasli akut kolanjit nedeniyle basvuran 178 hasta dahil edilerek retrospektif olarak gerçeklestirildi. Hastalar, endoskopik retrograd kolanjiopank- reatogra?nin yapildigi zamana göre iki gruba ayrildi: Ilk 72 saat içinde endoskopik retrograd kolanjiopankreatogra? yapilanlar “erken endoskopikretrograd kolanjiopankreatogra? grubu”, 72 saatten sonra endoskopik retrograd kolanjiopankreatogra? yapilanlar ise “geç endoskopik retrogradkolanjiopankreatogra? grubu” olarak sini?andirildi. Uzun hastanede yatisi öngören faktörlerin belirlenmesi amaciyla çok degiskenli regresyon analizi yapildi.Bulgular:Erken endoskopik retrograd kolanjiopankreatogra? grubunda, kabul ile endoskopik retrograd kolanjiopankreatogra?arasindaki medyan süre 41 (23-52) saat, geç endoskopik retrograd kolanjiopankreatogra? grubunda ise 114 (94-137) saat olarak saptandi. Erkenendoskopik retrograd kolanjiopankreatogra? grubunda hastanede yatis süresi, geç endoskopik retrograd kolanjiopankreatogra? grubuna kiyasla anlamli derecede daha kisaydi [6 (4-8) gün vs 9 (6-10) gün, p < 0.001]. Geç endoskopik retrograd kolanjiopankreatogra? grubunda daha yüksekoranda uzamis yatisa sahip hasta vardi [34 (%38.2) vs 13 (%14.6), p < 0.001]. Her iki grup arasinda bakteriyemi, yogun bakimda yatis, mortaliteve endoskopik retrograd kolanjiopankreatogra? komplikasyonlari açisindan fark bulunmadi. Çok degiskenli analizde, yas (OR: 1.032, %95 CI:1.005-1.060), endoskopik retrograd kolanjiopankreatogra? zamani (OR: 1.545, %95 CI: 1.240-1.925) ve total bilirubin düzeyi (OR: 1.198, %95 CI: 1.075-1.336) uzun hastane yatisini öngören bagimsiz risk faktörleri olarak tespit edildi.Sonuç:Ha?f tasli akut kolanjit hastalarinda, 72 saatten sonra yapilan geç endoskopik retrograd kolanjiopankreatogra? hastane yatis süresini uzatir.
Abstract
Background and Aims:While early endoscopic retrograde cholangiopancreatography is currently recommended in moderateto severe acute cholangitis, the optimal timing of endoscopic retrograde cholangiopancreatography in mild acute cholangitis is controversial. In our study, we examined the effect of endoscopic retrograde cholangiopancreatography time on hospital stay in mild calculous acute cholangitis, whichis the most common cause of acute cholangitis. We also investigated the factors predicting prolonged hospitalization.Materials and Methods:The study was conducted retrospectively, including 178 patients who presented with mild calculous acute cholangitis between February 2019 and April 2021. The patients included in the study were divided into two groups according to the endoscopic retrograde cholangiopancreatographytiming; those performed in the ?rst 72 hours were assigned as the early endoscopic retrograde cholangiopancreatography group, and those per-formed after 72 hours were assigned as the late endoscopic retrograde cholangiopancreatography group. Multivariate regression analysis was performed to ?nd factors predicting prolonged hospitalization.Results:The median time from admission to endoscopic retrograde cholangiopan-creatography was 41 (23-52) hours in the early endoscopic retrograde cholangiopancreatography group and 114 (94-137) hours in the late endo-scopic retrograde cholangiopancreatography group. The hospital stay was shorter in the early endoscopic retrograde cholangiopancreatography group [6 (4-8) vs 9 (6-10), p < 0.001]. The late endoscopic retrograde cholangiopancreatography group had a higher proportion of patients withprolonged hospitalization [34 (38.2%) vs 13 (14.6%), p < 0.001]. There was no difference between the two groups in terms of bacteremia, intensivecare hospitalization, mortality and endoscopic retrograde cholangiopancreatography complications. In multivariate analysis, age (OR: 1.032, 95%CI: 1.005-1.060), endoscopic retrograde cholangiopancreatography timing (OR: 1.545, 95% CI: 1.240-1.925), and total bilirubin (OR: 1.198, 95% CI: 1.075-1.336) were found to be independent risk factors predicting prolonged hospitalization.Conclusion:In patients with mild calculous acute cholangitis, delayed endoscopic retrograde cholangiopancreatography performed after 72 hours prolongs the length of hospital stay.
