胆管メタリックステント留置後の胆嚢炎の発症機序に関する検討

書誌事項

タイトル別名
  • Acute cholecystitis after expandable metal stent placement for malignant biliary obstruction

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説明

Expandable metal stents (EMS) are placed for palliation of patients with biliary obstruction. Acute cholecystitis is one of the complications experienced with the therapy, which disturbs the benefit from the therapy. We statistically evaluated the factors associated with cholecystitis after EMS placement. Among 188 patients received EMS placement, ten (7 pancreatic cancers,3 bile duct cancers 5.3%) had acute cholecystitis. In all patients with acute choelecystitis, percutaneous gallbladder drainage was performed. Aspirated bile culture revealed Klebsiella pneumoniae, K. oxytoca, and Enterococcus faecalis in two, two, and one, respectively. Statistically, covered EMS placement to those with gallbladder stones, EMS placement over the cystic duct confluence, and EMS placement to those with cystic ducts obstruction due to tumor invasion are significantly associated with acute cholecystitis. Cholangitis recognized on EMS placement is not responsible for acute cholecystitis. EMS placement over the duodenal papilla has relation with acute cholecystitis, but not significantly. These results suggest that acute cholecystitis after EMS placement occurs by the other mechanisms than retrograde infection through the bile duct via the major papilla.

収録刊行物

  • Tando

    Tando 20 (2), 142-146, 2006

    Japan Biliary Association

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