The effects of efficient usage of endosonography in the daily medical practice of gastroenterology

Yıl 2010, Cilt: 9 Sayı: 3, 93 - 97, 01.12.2010

Emrah Alper Behlül Baydar Zafer Buyraç Fatih Aslan Uğur Özgürbüz Cengiz Tavusbay İşık Alper Belkıs Ünsal

Öz

Background and Aims: Our aim was to evaluate the efficient use of endosonography in the daily practice of gastroenterology. Material and Methods: Our study was done retrospectively in a tertiary hospital. Data including patient demographics, diagnosis, duration of hospital stay, endoscopic retrograde cholangiopancreatography procedure, and radiologic diagnostic tests were evaluated between June 2008 and June 2009 (Period 1) and between June 2009 and June 2010 (Period 2). Therapeutic endoscopic retrograde cholangiopancreatography rates, biliary tract evaluation rates with magnetic resonance cholangiopancreatography, cytologic sampling rates from pancreatic masses, diagnostic rates of chronic pancreatitis, and duration of hospital stay of acute biliary pancreatitis patients were compared between the two periods. Results: Endoscopic ultrasound was performed in 187 and 2027 patients in Periods 1 and 2, respectively. The ratios of therapeutic endoscopic retrograde cholangiopancreatography were 71.3% and 90.7% and the numbers of patients requiring magnetic resonance cholangiopancreatography were 617 and 29 in Periods 1 and 2, respectively. Biopsy was conducted with transabdominal US in 24 of 81 patients in Period 1; tissue sampling was done with linear endosonography in 155 of 187 patients in Period 2. The numbers of patients with recently diagnosed chronic pancreatitis in Periods 1 and 2 were 8 and 51, respectively; the mean hospital stays of acute biliary pancreatitis patients were 11.6 ± 5.4 and 7.8 ± 4.5 days, respectively. Conclusions: In this study, we determined that the efficient use of endosonography increases the therapeutic endoscopic retrograde cholangiopancreatography rates, the diagnostic rates of chronic pancreatitis patients and the tissue diagnostic rates of pancreatic masses; it also diminishes the endoscopic retrograde cholangiopancreatography appointment time and the hospitalization duration of acute biliary pancreatitis patients. We believe that endosonography should be the responsibility of only one physician in a clinic in order to increase their experience.

Anahtar Kelimeler

Endosonography, gastroenterology, practice guideline

Endosonografinin etkin kullanımının gastroenteroloji günlük tıbbi pratiğine etkileri

Öz

Giriş ve Amaç: Endosonografinin etkin kullanımının gastroenteroloji günlük pratiğine etkilerini değerlendirmeyi amaçladık. Gereç ve Yöntem: Çalışmamız, tersiyer bir hastanede retrospektif olarak yapıldı. Haziran 2007Haziran 2008 (Dönem 1) ve Haziran 2009Haziran 2010 (Dönem 2) arasında hasta demografikleri, tanıları, yatış gün sayısı, endoskopik retrograd kolanjiyopankreatografi işlemi, radyolojik tanı yöntemleri kullanılan hastalara ait veriler değerlendirildi. Dönemlere göre; terapötik endoskopik retrograd kolanjiyopankreatografi oranları, manyetik rezonans kolanjiyopankreatografi ile safra yolu değerlendirme oranları, pankreas kitlelerinden sitolojik örnekleme oranları, kronik pankreatit tanı oranları, akut biliyer pankreatitli hastalarda hastane yatış süreleri karşılaştırıldı. Bulgular: Dönem 1'de 187, dönem 2'de 2027 endosonografi işlemi yapıldı. Terapötik endoskopik retrograd kolanjiyopankreatografi oranı Dönem 1 ve 2'de sırasıyla %71,3 ve %90,7; manyetik rezonans kolanjiyopankreatografi gereken hasta sayısı 617 ve 29 idi. Dönem 1'de 81 hastanın 24'ünde transabdominal ultrasonografi ile biyopsi alındı, Dönem 2'de 187 hastanın 155'inde lineer endosonografi ile doku örneklemesi yapıldı. Yeni tanı konulan kronik pankreatitli hasta sayısı Dönem 1 ve 2'de sırasıyla 8 ve 51 hasta; akut biliyer pankreatitli hastaların ortalama yatış günü 11,6 ± 5,4 gün ve 7,8 ± 4,5 gün idi. Sonuç: Bu çalışmada, endosonografinin etkin kullanımının terapötik endoskopik retrograd kolanjiyopankreatografi oranını, kronik pankreatit tanı koyma oranını, pankreatik kitlelerde doku tanısı koyma oranını arttırdığını, endoskopik retrograd kolanjiyopankreatografi randevu gününü ve akut biliyer pankreatitli hastalarda yatış süresini kısalttığını saptadık. Etkin endosonografi kullanımı için, bir hekimin sadece endosonografi ile ilgilenmesi ve endosonografi tecrübesini arttırması gerektiğini düşünmekteyiz.

Anahtar Kelimeler

Endosonografi, gastroenteroloji, pratik ana hatlar

Kaynakça

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