Esat Taylan UĞURLU, Mehlika BİLGİ KIRMACI

Akut Pankreatitte ERCP’nin Mortalite ve Morbiditeye Etkisi

Amaç: Ülkemizde akut pankreatitin (AP) en önemli nedeni safra taşı ve safra çamurudur. Endoskopik retrograd kolan-jiyopankreatografi (ERCP) uzun yıllardır akut biliyer pankreatitin (ABP) tanı ve tedavisinde kullanılmaktadır. Akut biliyer pankreatitli hastanın tedavisi; güncel uluslararası kılavuzlar eşliğinde değerlendirilmelidir. Bu çalışmada akut biliyer pankreatit tanısı ile kliniğimize yatırılan ve tedavi amacıyla Endoskopik Retrograde Kolanjio pankreotografi (ERCP) yapılan hastaları literatür eşliğinde analiz etmeyi amaçladık.Materyal ve metod: Nisan 2020-Mart 2021 tarihleri arasında akut biliyer pankreatit tanısıyla Genel Cerrahi Endos-kopi Ünitemizde ERCP yapılan hastaların kayıtları retrospektif olarak incelendi.Bulgular: kut biliyer pankreatit tanısı alan 131 hastaya ERCP yapıldı. Hastaların 60’ı (%45,8) erkek, 71’i(%54,2) kadındı. Hastaların 121’i (%92,36) koledok taşı, 9’u(%6,87) periampuller/koledok distal uç tümörü, 1’i(%0,76) kist hadatik ameliyatı sonrası safra yollarına kist rüptürüne bağlı Akut Pankreatit nedeniyle ERCP’ ye alınmışlardı. 30 hastaya ERCP, endoskopik sfinkterotomi (ES) ve koledoğa plastik stent yerleştirilmesi işlemi yapılırken 99 hastaya ERCP, ES ve kole-doktan taş ekstraksiyonu işlemi yapıldı. Operatif mortalite olmadı.Sonuç: Akut pankreatit; hafif ödematöz pankreatitten, %20 mortaliteye sahip şiddetli nekrotizan pankreatite kadar uzanan, oldukça heterojen dağılıma sahip bir hastalıktır; tanı ve tedavisinde halen birçok tartışmalı konu mevcuttur. Ancak biliyer pankreatitte minimal invaziv bir işlem olan Endoskopik retrogratkolanjiopankreatografi tanı-teşhis ve tedavi sağlaması bakımından ilk planda tutulmalıdır.

Anahtar Kelimeler:

Acute biliary pancreatitis, Endoscopic retrograde cholangiopancreatography, choledocholithiasis

The Effect of ERCP on Mortality and Morbidity in Acute Pancreatitis

Background: Gallstones and biliary sludge are the most important causes of acute pancreatitis (AP) in our country. For many years, endoscopic retrograde cholangiopancreatography (ERCP) has been used to diagnose and treat acute biliary pancreatitis (ABP). The patient's treatment with acute biliary pancreatitis should be assessed in light of current international guidelines. This study aimed to analyze the patients who were admitted to our clinic with the diagnosis of acute biliary pancreatitis and underwent Endoscopic Retrograde Cholangiopancreatography (ERCP) for treatment, in the light of the literature.Materials and Methods: The records of patients who underwent ERCP with a diagnosis of acute biliary pancreatitis in our general surgery endoscopy department between April 2020 and March 2021 were retrospectively reviewed.Results: ERCP was performed in 131 patients with acute biliary pancreatitis. 60 (45.8%) of the patients were male, whereas 71 (54.2%) were female. ERCP was performed on 121 (92.36%) patients for common choledochal stones, 9 (6.87%) for periampullary/distal end of the choledochal tumor, and 1 (0.76%) for acute pancreatitis due to biliary tract rupture after hepatic cyst surgery. While 30 patients underwent ERCP, endoscopic sphincterotomy (ES), and the placement of a plastic stent in the common bile duct, 99 patients underwent ERCP, ES, and stone extraction from the common bile duct. There was no operative mortality.Conclusions: Acute pancreatitis is a very heterogeneous disease, ranging from mild edematous pancreatitis to severe necrotizing pancreatitis with a mortality of 20%. There are still many controversial issues in the diagnosis and treat-ment of this disease. However, endoscopic retrograde cholangiopancreatography, a minimally invasive biliary pan-creatitis procedure, should be at the forefront of diagnosis and treatment.Keywords: Acute biliary pancreatitis, Endoscopic retrograde cholangiopancreatography, choledocholithiasis

Keywords:

Acute biliary pancreatitis, Endoscopic retrograde cholangiopancreatography, choledocholithiasis Acute biliary pancreatitis, Endoscopic retrograde cholangiopancreatography, choledocholithiasis,

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