Perkütan Kolesistostominin Akut Kolesistit Tedavisindeki Yeri

Yıl 2023, , 70 - 83, 16.03.2023

Erbil Arık , Asım Esenkaya , Fatih Altıntoprak

https://doi.org/10.31832/smj.1215454

Öz

Amaç: Çalışmamızda perkütan kolesistostominin (PK) hastaların klinik ve laboratuvar bulgularına etkisini araştırdık.

Gereç ve Yöntem: Çalışmamıza Şubat 2017 ile Kasım 2018 tarihleri arasında PK yapılan 36 hasta dahil edildi.Hastaların işlem öncesi ve sonrası klinik ve laboratuvar bulguları retrospektif olarak tarandı.

Bulgular: Hastalarımızda rekürrens görülmemiştir. PK işlemi ile ilişkili mortalite ya da komplikasyon izlenmemiştir. Kateterin takılı kalma süresi 50,2 ± 26,1 gün, hastane yatış süresi 7,5 ± 5,2 gün olarak belirlenmiştir. Total bilirubin değeri ve beyaz küre sayısı yüksek olan hasta sayısında işlem öncesi ve sonrası arasında istatistiksel olarak anlamlı fark saptanmıştır. ALT, ALP, CRP, beyaz küre sayısı, total ve direkt bilirubin parametrelerinin işlem öncesi ve sonrası değerleri arasında da istatistiksel olarak anlamlı fark saptanmıştır. Tokyo kılavuzu evresi ile yoğun bakım ihtiyacı arasında istatistiksel olarak anlamlı fark saptanmış olup yoğun bakımda tedavi gösteren tüm hastalar evre 3’tür.PK sonrasında cerrahiye giden hastaların yaş ortalaması diğer gruba göre daha yüksektir.

Sonuç: İşlem sonrasında beyaz küre sayısı ve CRP değerinde anlamlı düşüş ve hastaların çoğunluğunda klinik düzelme görülmesi PK’nin A.K kaynaklı enflamatuar süreçleri olumlu yönde etkilediğini göstermektedir. Çalışmamızda işlem sonrasında ALT ve ALP değerlerinde anlamlı düşüş saptanmış olup, bu bulgu bildiğimiz kadarıyla literatürde ilk kez tanımlanmıştır.

Anahtar Kelimeler

akut kolesistit, perkütan kolesistostomi, perkütan safra kesesi drenajı, safra kesesi, kolesistektomi

Kaynakça

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