Mustafa KAPLAN, Bülent ÖDEMİŞ, Selçuk DİŞİBEYAZ, Erkan PARLAK, Erkin ÖZTAŞ, Volkan GÖKBULUT, Orhan COŞKUN

Endoskopik transpapiller safra kesesi drenajı: Tek merkez deneyimi

Giriş ve Amaç: Bu çalışmada komorbit durumların eşlik ettiği sistik kanal veya safra kesesi ilişkili hastalıklarda ERCP ile transpapiller safra kesesi drenajının teknik ve klinik başarısını ve komplikasyonlarını araştırdık. Gereç ve Yöntem: Bu çalışma 2011-2017 yılları arasında koledok taşı, kolanjit veya Mirizzi sendromu nedeniyle endoskopik retrograd kolanjiopankreotografi endikasyonu zaten konulan ve eşlik eden akut kolesistiti olan toplam 19 hasta ile yapıldı. Endikasyona göre koledok taşları ve sistik kanal taşları çıkarıldıktan veya koledoğa stent yerleştirildikten sonra tüm hastalarda nazosistik dren veya pigtail stent ile transpapiller safra kesesi drenajı sağlandı. Transpapiller safra kesesi drenajının teknik ve klinik başarısı ve işlemin komplikasyonları değerlendirildi. Bulgular: Hastaların 15’inde (%79) en az bir komorbid hastalık vardı. 10 hastada sistik kanalda taş izlendi. Sistik kanalında taş olan tüm hastalara balon ile lavaj, 3 hastaya basket ve mekanik litotripsi ve bir hastaya da sistik kanal girişine balon dilatasyonu uygulandı. Transpapiller safra kesesi drenajı 8 hastada 7F nazosistik dren, 6 hastada 7F nazobiliyer drenden yapılma stent, 3 hastada 7F double pigtail stent ve 2 hastada 10F double pigtail stent ile sağlandı. Çalışmada transpapiller safra kesesi drenajının teknik başarısı %100 ve klinik başarısı %89 olarak bulundu. İşleme bağlı ölüm dahil herhangi bir komplikasyon görülmedi. Sonuç: Komorbit durumların eşlik ettiği safra kesesi veya sistik kanal ile ilişkili hastalıklarda endoskopik retrograd kolanjiopankreotografi ile transpapiller safra kesesi drenajı başarılı ve komplikasyonu az bir yöntemdir.

Anahtar Kelimeler:

Akut kolesistit, safra kesesi drenajı, endoskopik retrograd kolanjiopankreotografi

Endoscopic transpapillary gallbladder drainage: Single center experience

Objective: In this study, we investigated the technical and clinical success and complications of transpapillary gallbladder drainage with endoscopic retrograde cholangiopancreatography in patients with gallbladder or cystic duct related diseases accompanied by comorbid conditions.Material and Methods: This study was performed on 19 patients with acute cholecystitis who had already an indication for endoscopic retrograde cholangiopancreatography due to choledocholitiasis, cholangitis or Mirizzi syndrome between 2011-2017. After choledochal and cystic duct stones had been removed, or choledochal stents had been placed according to indication, transpapillary gallbladder drainage with nasocystic drain or pigtail stent were provided in all patients. The technical and clinical success of transpapillary gallbladder drainage and the complications of the procedure were evaluated.Results: 15 (79%) of the patients had at least one comorbid disease. Cystic duct stones were observed in 10 patients. Balloon lavage to all patients with cystic duct stones, basket and mechanical lithotripsy to 3 patients, and balon dilatation to the entrance of cystic duct to one patient were applied. Transpapillary gallbladder drainage was provided with 7F nasocystic drain in 8 patients, stent made from 7F nasobiliary drain in 6 patients, 7F double pigtail stent in 3 patients and 10F double pigtail stent in 2 patients. In this study, the technical success of transpapillary gallbladder drainage was found 100% and clinical success was found 89%. No complications including death were observed due to the procedure.Conclusion: Transpapillary gallbladder drainage with endoscopic retrograde cholangiopancreatography is a successful and less complicated procedure in patients who have gallbladder or cystic duct related diseases with comorbid conditions.

Keywords:

Acute cholecystitis, gallbladder drainage, endoscopic retrograde cholangiopancreatography,

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ISSN: 1302-5422
Başlangıç: 2010
Yayıncı: Türk Gastroenteroloji Vakfı

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