응급 내시경역행췌담관조영술 시행 급성 담관염 환자 분석; 급성 담관염 환자에서 응급 내시경역행췌담관조영술 시행을 예측하게 하는 요인은 무엇인가? (Clinical Analysis of Acute Cholangitis; Prognostic Factors for Emergency Endoscopic Retrograde Cholangiopancreatography)

서지정보

· 발행기관 : 대한응급의학회
· 수록지 정보 : 대한응급의학회지 / 20권 / 4호 / 428 ~ 434페이지
· 저자명 : 김균무, 이경원

초록

Purpose: Acute cholangitis is a life-threatening biliary complication.
Medical treatment is the first-line therapy in
patients with acute cholangitis, but those who fail to
respond to antibiotic treatment require urgent biliary decompression.
This study was undertaken in order to determine
predictive factors for emergency endoscopic retrograde
cholangiopancreatography (ERCP).
Methods: This was a retrospective observation study with
data from Daegu Catholic University Hospital, Emergency
Department (ED). Between Jan 2005 and Dec 2007, 317
patients were enrolled into this study. Inclusion criteria for
patients were a final diagnosis: acute cholangitis, and an
ERCP from ED visit. We defined emergency ERCP, as
ERCP done within 24 hours of an ED visit. We analyzed
the medical data by using SPSS 14.0 and compared the
Emergency ERCP group to the Elective (Non emergency)
ERCP group with regard to age, sex, vital signs on ED,
symptom onset time, mortality, and various laboratory tests.
Results: Access to ED and laboratory tests (such as aspartate
transaminase (AST) and alanine transaminase (ALT)
were factors that showed statistically significant differences
between the ERCP group (n=289) and Elective ERCP
group (n=28) by the Chi-square test and the t-test by each.
There were no statistical differences in other factors by
independent t test or Chi-square test. Multiple logistic
regression showed access to ED; a laboratory test such as
AST were predictive factors for emergency ERCP.
Conclusion: The result of this study indicates that the EP
(Emergency physician) should pay attention to the acute
cholangitis patients who visit the ED with an abnormal laboratory
test. In the timely consultation to the endoscopist, EP
plays a key role in the treatment of acute cholangitis.

영어초록

Purpose: Acute cholangitis is a life-threatening biliary complication.
Medical treatment is the first-line therapy in
patients with acute cholangitis, but those who fail to
respond to antibiotic treatment require urgent biliary decompression.
This study was undertaken in order to determine
predictive factors for emergency endoscopic retrograde
cholangiopancreatography (ERCP).
Methods: This was a retrospective observation study with
data from Daegu Catholic University Hospital, Emergency
Department (ED). Between Jan 2005 and Dec 2007, 317
patients were enrolled into this study. Inclusion criteria for
patients were a final diagnosis: acute cholangitis, and an
ERCP from ED visit. We defined emergency ERCP, as
ERCP done within 24 hours of an ED visit. We analyzed
the medical data by using SPSS 14.0 and compared the
Emergency ERCP group to the Elective (Non emergency)
ERCP group with regard to age, sex, vital signs on ED,
symptom onset time, mortality, and various laboratory tests.
Results: Access to ED and laboratory tests (such as aspartate
transaminase (AST) and alanine transaminase (ALT)
were factors that showed statistically significant differences
between the ERCP group (n=289) and Elective ERCP
group (n=28) by the Chi-square test and the t-test by each.
There were no statistical differences in other factors by
independent t test or Chi-square test. Multiple logistic
regression showed access to ED; a laboratory test such as
AST were predictive factors for emergency ERCP.
Conclusion: The result of this study indicates that the EP
(Emergency physician) should pay attention to the acute
cholangitis patients who visit the ED with an abnormal laboratory
test. In the timely consultation to the endoscopist, EP
plays a key role in the treatment of acute cholangitis.

참고자료

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