AIM: To evaluate the yield of brushing biliary strictures and the factors associated with a positive result in biliary strictures. METHODS: Data on all consecutive patients (01/02 -10/05) who were identified to have a...AIM: To evaluate the yield of brushing biliary strictures and the factors associated with a positive result in biliary strictures. METHODS: Data on all consecutive patients (01/02 -10/05) who were identified to have a biliary stricture and who underwent biliary brush cytology were collected. The yield of positive biliary brush cytology was evaluated and compared to results with the gold standard for diagnosis (defi ned as either defi nitive surgical histology or clinical course). Additionally,associated factors of positive results including stricture location,gender,age,mass size,length of stricture,and dilatation prior to brushing cytology were assessed. RESULTS: From 199 patients who had brushing cytology samples (10 patients were excluded due to lack of gold standard diagnosis),77 patients had positive brushing cytology (yield 41%). Variables associated with positive cytology brushing on initial endoscopic retrograde cholangiography were age 1.02 (1.00-1.05),mass size > 1 cm 2.22 (1.01-4.89) and length of stricture > 1 cm 3.49 (1.18-10.2). The sensitivity of biliary brushing was 61%,its specifi city 98%,the positive predictive value reached 99%,and the negative predictive value was 57%. CONCLUSION: Our results revealed a 41% positive yield from brushing cytology. The sensitivity of biliary brushing cytology in our center was 61% and the specif icity was 98%. Predictors of positive yield include older age,mass size > 1 cm,and stricture length of > 1 cm.展开更多
目的:探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)+腹腔镜胆总管探查取石术(laparoscopic common bile duct exploration,LCBDE)与内镜逆行胰胆管造影(endoscopic retrograde cholangiopancreatography,ERCP)/内镜十二指肠...目的:探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)+腹腔镜胆总管探查取石术(laparoscopic common bile duct exploration,LCBDE)与内镜逆行胰胆管造影(endoscopic retrograde cholangiopancreatography,ERCP)/内镜十二指肠乳头括约肌切开术(endoscopic sphincterotomy,EST)+LC治疗胆囊结石合并胆总管结石的临床效果。方法:选择2013年12月至2016年12月收治的135例胆囊结石合并胆总管结石患者,分为LC+LCBDE组(n=84)与ERCP/EST+LC组(n=51),对比观察两组术中情况(手术成功率、结石残留率、手术时间、出血量)、术后情况(腹腔引流管留置时间、胃肠功能恢复时间及术后并发症)、住院时间及治疗费用。结果:两组手术成功率、并发症发生率差异无统计学意义;LC+LCBDE组手术时间、术中出血量、术后胃肠功能恢复时间、腹腔引流管放置时间多于ERCP/EST+LC组,但住院时间、住院费用优于ERCP/EST+LC组。结论:治疗胆囊结石合并胆总管结石两种术式均安全、有效,各有优缺点,应根据患者情况、医院设备及医疗水平,结合胆总管结石数量、直径等,慎重选择手术方式。展开更多
文摘AIM: To evaluate the yield of brushing biliary strictures and the factors associated with a positive result in biliary strictures. METHODS: Data on all consecutive patients (01/02 -10/05) who were identified to have a biliary stricture and who underwent biliary brush cytology were collected. The yield of positive biliary brush cytology was evaluated and compared to results with the gold standard for diagnosis (defi ned as either defi nitive surgical histology or clinical course). Additionally,associated factors of positive results including stricture location,gender,age,mass size,length of stricture,and dilatation prior to brushing cytology were assessed. RESULTS: From 199 patients who had brushing cytology samples (10 patients were excluded due to lack of gold standard diagnosis),77 patients had positive brushing cytology (yield 41%). Variables associated with positive cytology brushing on initial endoscopic retrograde cholangiography were age 1.02 (1.00-1.05),mass size > 1 cm 2.22 (1.01-4.89) and length of stricture > 1 cm 3.49 (1.18-10.2). The sensitivity of biliary brushing was 61%,its specifi city 98%,the positive predictive value reached 99%,and the negative predictive value was 57%. CONCLUSION: Our results revealed a 41% positive yield from brushing cytology. The sensitivity of biliary brushing cytology in our center was 61% and the specif icity was 98%. Predictors of positive yield include older age,mass size > 1 cm,and stricture length of > 1 cm.
文摘目的:探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)+腹腔镜胆总管探查取石术(laparoscopic common bile duct exploration,LCBDE)与内镜逆行胰胆管造影(endoscopic retrograde cholangiopancreatography,ERCP)/内镜十二指肠乳头括约肌切开术(endoscopic sphincterotomy,EST)+LC治疗胆囊结石合并胆总管结石的临床效果。方法:选择2013年12月至2016年12月收治的135例胆囊结石合并胆总管结石患者,分为LC+LCBDE组(n=84)与ERCP/EST+LC组(n=51),对比观察两组术中情况(手术成功率、结石残留率、手术时间、出血量)、术后情况(腹腔引流管留置时间、胃肠功能恢复时间及术后并发症)、住院时间及治疗费用。结果:两组手术成功率、并发症发生率差异无统计学意义;LC+LCBDE组手术时间、术中出血量、术后胃肠功能恢复时间、腹腔引流管放置时间多于ERCP/EST+LC组,但住院时间、住院费用优于ERCP/EST+LC组。结论:治疗胆囊结石合并胆总管结石两种术式均安全、有效,各有优缺点,应根据患者情况、医院设备及医疗水平,结合胆总管结石数量、直径等,慎重选择手术方式。
