Dissertation > Excellent graduate degree dissertation topics show

The Clinical Value of Early Endoscopic Treatment in Severe Acute Biliary Pancreatitis

Author: ZhongYuChuan
Tutor: CuiNaiQiang
School: Tianjin Medical University
Course: Integrative Medicine Surgery
Keywords: acute biliary pancreatitis early endoscopic therapy ERCP EST
CLC: R657.51
Type: Master's thesis
Year: 2013
Downloads: 2
Quote: 0
Read: Download Dissertation

Abstract


Objective:To evaluate whether there is difference in efficacy between early non-surgical treatment and early endoscopic treatment in severe acute biliary pancreatitis (SABP).Methods:This prospective randomized study was performed from September2010to November2012.54cases were randomly divided into early non-surgical treatment group (ENT) or early endoscopic treatment group (EET, endoscopic therapy performed within72hours). Outcome measures included changes in APACHE-Ⅱ, SOFA and Balthazar CT scores during the first week after admission, incidence of local complications, and overall morbidity and mortality.Results:1. The clinical data of ENT group and EET group, including the sex ratio (P=0.76), age (P=0.43), time of onset (P=0.80), the admission serum total bilirubin (P=0.92), glucose (P=0.38), are no significant differences and highly comparable.2. There was no significant difference of the mean APACHE-Ⅱ scores between the EET group and ENT group at the time of admission and1,2,3,7days later (P=0.14,0.13,0.20,0.18,0.43). The mean APACHE-Ⅱ scores of ENT group in the five time points above were12.13±3.27,7.90±4.28,6.07±3.77,5.10±3.37and4.47±3.63respectively. And the corresponding scores of EET group were12.25±3.39,6.08±4.24,4.75±3.21,3.92±2.32and3.75±2.45.3. There was no significant difference of the mean SOFA scores between the ENT group and EET group at the time of admission and1,2,3,7days later (P=0.82,0.56,0.75,0.77,0.55). The mean SOFA scores of ENT group in the five time points above were1.37±1.16,1.07±1.11,0.93±1.14,0.77±1.07and0.73±1.05. And the corresponding scores of EET group were1.42±1.06,1.25±1.11,0.83±1.01,0.71±1.00and0.58±1.06.4. There was no significant difference of the mean Balthazar CT scores between the ENT group and EET group at the time of admission and7days later. The mean Balthazar CT scores of ENT group in the two time points above were2.67±1.27and 2.63±1.35. The mean Balthazar CT scores of EET group in the two time points above were2.25±1.07and2.25±1.11. The mean scores of ENT group decreased by0.03±0.81, and the EET group was reduced0.08±0.72. There was no significant difference between the two groups (the probability of ENT group was0.27; the probability of EET group was0.21).5. The total organ failure rates of ENT group (43.3%) and the EET group (37.5%) were no significantly different (P=0.67). The total local complication rates of the two groups were20.0%and25.0%, compared to no significant difference (P=0.87).Conclusion:Compared with early nonsurgical treatment, early endoscopic treatment did not significantly reduce the systemic and local morbidity and overall mortality in severe acute biliary pancreatitis.

Related Dissertations

  1. Computational Identification and Characterization of Microrna Genes from Agricultural Insects,S186
  2. Analysis of Influencing Factors of Post-endoscopic Retrograde Cholangiopancreatography Pancreatitis,R576
  3. Investigate the Value of CT Reconstruction of Multi-mode After T-tube Cholangiography or ERCP in the Biliary Tract Disease,R657.4
  4. The Clinical Summary of Application of MAC in ERCP,R614
  5. The Clinical Value of and Curative Effect of Therapeutic ERCP in Serious Pancreatic Diseases,R657.51
  6. Preoperative EST Compared with Intraoperative EST for Patients with Gallstones,R657.4
  7. Studies on EST-SSR and SRAP Markers in Flax,S563.2
  8. The Clinical Analysis of EST Combined with LC in Treating Gallstone and Common Bile Duct Stones,R657.4
  9. Contrast Research of Different Imaging Diagnosis Methods on Obstructive Jaundice,R657.4
  10. The Research of Minimally Invasive Surgery on Acute Biliary Pancreatitis,R657.4
  11. The Pathology Analysis of the Duodenal Nipple for 36 Cases of Sphincter of Oddi Dysfunction Patient,R657.4
  12. Development and Application of EST-SST Marker in Pepper,S641.3
  13. The Study and Analysis of Related Risk Factors of Late Complications after Endoscopic Sphincterotomy,R657.4
  14. Study on the Operation Opportunity of Severe Acute Biliary Pancreatitis,R657.51
  15. ERCP in Patients with Acute Biliary Pancreatities a Reports of 50 Cases,R657.51
  16. Health Economic Assessment on ERCP and Open Abdomen Operation in Treating Common Bile Duct Stone,R657.4
  17. Study of the Etiology and Treatment of Biliary Complications after Adult Orthotopic Liver Transplantation,R657.3
  18. Molecular Cloning, Ectopic Expression and Subcellular Localization of a Soybean BURP Domain-containing Protein Gene,Q943.2
  19. Development of EST-SSR Primers and Application in Analysis of Genetic Realtionships in Tree Peony,S685.11
  20. Isolationg and Characterization of SNPs from EST Database of Pacific Oyster (Crassostrea Giga),S917.4
  21. Molecular Cloning and Analysis of Histone H3 Genes from Triticum Aestivum,Q943.2

CLC: > Medicine, health > Surgery > Of surgery > Abdominal surgery > Pancreas > Pancreatitis
© 2012 www.DissertationTopic.Net  Mobile