Nazobiliyer drenaja bağlı akut böbrek yetmezliği gelişebilir mi?

Year 2014, , - , 01.08.2014

Erkin Öztaş Nuretdin Suna Ufuk Barış Kuzu Orhan Çoşkun Bülent Ödemiş Selçuk Dişibeyaz Ertuğrul Kayaçetin

https://doi.org/10.17940/endoskopi.74785

Abstract

Nazobiliyer drenaj başlıca; akut süpüratif kolanjit, safra yollarına açılmış kist hidatik, postoperatif safra kaçakları ve kolestaz ilişkili özellikle kaşıntı gibi semptomların giderilmesinde tercih edilen endoskopik drenaj metodlarından biridir. Nazobiliyer drenajın çeşitli avantajlarının yanında, işlem süresini uzatması, oral kaviteden nazal yola geçirirken nadir de olsa zedelenmeye sebep olması, uyumsuz hastalarda kateterin yerinden çıkması ve hastada rahatsızlık hissi oluşturması gibi dezavantajları söz konusudur. Ancak nazobiliyer drenaj nedeniyle akut böbrek yetmezliği gelişimi ile ilgili literatürde bir veri yoktur. Burada koledok distalde muhtemel malign darlık ön tanısı ile nazobiliyer drenaj konulup cerrahiye refere edilen ancak bu süreçte aşırı biliyer drenaj ilişkili akut böbrek yetmezliği gelişen olguyu sunuyoruz.

Keywords

Nazobiliyer drenaj, akut böbrek yetmezliği

Can acute renal failure occur due to nasobiliary drainage?

Abstract

Nasobiliary drainage, an endoscopic drainage method, is used mainly for the treatment of symptoms such as acute suppurative cholangitis, hydatid cyst rupture into the bile duct, postoperative biliary drainage, and pruritus associated with cholestasis. In addition to its various benefits, nasobiliary drainage has disadvantages, including prolongation of the procedure, damage while passing from the oral cavity to nasal route, though rare, dislocation of the catheter in incompatible patients, and patient discomfort. However, there is no previous report in the literature indicating the occurrence of acute renal failure due to nasobiliary drainage. In this report, we present a case who was referred to surgery after nasobiliary drainage placement due to a preliminary diagnosis of malignant narrowing in the distal choledochus; however, acute renal failure developed during the procedure because of excessive biliary drainage.

Keywords

Nasobiliary drainage, acute renal failure

References

• Nagai N, Toki F, Oi I, et al. Continuous endoscopic pancreatochole- dochal catheterization. Gastrointest Endosc 1976;23:78-81.
• Sharma BC, Reddy RS, Garg V. Endoscopic management of hepatic hy- datid cyst with biliary communication. Dig Endosc 2012;24:267-70.
• Yang J, Peng JY, Pang EJ, Chen W. Efficacy of endoscopic nasobiliary drainage for the prevention of post-endoscopic retrograde cholangio- pancreatography pancreatitis and cholangitis after repeated clearance of common bile duct stones: Experience from a Chinese center. Dig Endosc 2013;25:453-8.
• Horiuchi A, Nakayama Y, Kajiyama M, et al. Biliary stenting in the man- agement of large or multiple common bile duct stones. Gastrointest En- dosc 2010;71:1200-3.e2.
• Park DH, Kim MH, Lee SK, et al. Endoscopic sphincterotomy vs. endo- scopic papillary balloon dilation for choledocholithiasis in patients with liver cirrhosis and coagulopathy. Gastrointest Endosc 2004;60:180-5.
• Guyton AC, Hall JE. Textbook of Medical Physiology, WB Saunders Comp., USA, 2000.
• Lai ECS, Paterson IA, Tam PC, et al. Severe acutecholangitis: The role of emergency nasobiliarydrainage. Surgery 1990;107:268-72.