SCORE SYSTEM FOR ERCP INDICATING IN EXTRAHEPATIC BILE DUCT OBSTRUCTION

  • I. N. Mamontov
Keywords: ERCP, score system, urgent indication, acute cholangitis, acute biliary pancreatitis, impacted stone at duodenal papilla.

Abstract

Abstracts. Aim: to objectify indications for urgent/emergency ERCP in patients with extrahepatic biliary tract obstruction (EBTO) by using the score system

Matherials and Methods. The score is used by summing the points: hyperthermia ≥ 37.3 ° C (1 point); one of three hematological points — leukocytosis ≥ 9×109/l or stab neutrophils ≥ 7% or the ratio of the number of segmented and stab neutrophils <10 (1 point); two biochemical — serum bilirubin ≥ 70 μmol / l (1 point), hyperamylasemia (1 point); thickening of the gallbladder wall ≥ 4 mm or shrunken gallbladder (1 point); the main pancreatic duct dilatation (1 point); in the presence of a periampular tumor or signs of chronic pancreatitis, one point is subtracted (- 1 point).

The scale was tested on 171 patients with EBTO.

Results. The threshold value of the scale was ≥3 points (p <0.001). The number of points (3, ≥4) correlated with the severity of acute cholangitis and acute biliary pancreatitis (p <0.01).

Conclusions. In patients with confirmed OEDB in case of ≤2 points of the score system — urgent/emergency ERCP is not indicated; in case of ≥3 points — urgent ERCP is indicated; in case of ≥4 points emergency ERCP should be performed.

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Proposed new simple scoring system to identify indications for urgent ERCP in acute cholangitis based on the Tokyo Guidelines.

Published
2019-12-20
How to Cite
Mamontov, I. N. (2019). SCORE SYSTEM FOR ERCP INDICATING IN EXTRAHEPATIC BILE DUCT OBSTRUCTION. Kharkiv Surgical School, (3-4), 12-17. https://doi.org/10.37699/2308-7005.3-4.2019.02
Section
ORIGINAL RESEARCHES