PDF(Pubmed)
Abstract：
OBJECTIVE: Anesthesiologists prefer ketamine for certain surgeries due to its effectiveness as a non-competitive inhibitor of the N-methyl-D-aspartate receptor in the brain. Recently, this agent has also shown promise as an antidepressant. However, ketamine can cause hallucinogenic effects and is sometimes abused as an illicit drug. Ketamine abuse has been associated with liver and bile duct complications. This systematic study aims to better understand cholangiopathy in ketamine abusers by reviewing case reports.
METHODS: In this systematic review, a comprehensive literature search was conducted with the terms \"biliary tract diseases\" and \"ketamine\". Case reports and case series of adult patients with documented ketamine abuse and reported cholangiopathy or biliary tract disease were included. We extracted the data of relevant information and the results were reported through narrative synthesis and descriptive statistics.
RESULTS: A total of 48 studies were initially identified, and 11 studies were finally included in the review. The mean age of the patients was 25.88 years. Of the 17 patients, 64.7% were men. Symptoms often included abdominal pain, nausea, and vomiting. Most patients were discharged with improved symptoms and liver function. Common bile duct dilation and other findings were observed in imaging results and other diagnostic studies.
CONCLUSIONS: This review highlights the diverse presentations and diagnostic modalities used in ketamine-induced cholangiography. These patients tend to be young men with deranged liver function tests and abdominal pain, which should be taken into consideration. These patients often require a multidisciplinary approach in their management.
METHODS: In this systematic review, a comprehensive literature search was conducted with the terms \"biliary tract diseases\" and \"ketamine\". Case reports and case series of adult patients with documented ketamine abuse and reported cholangiopathy or biliary tract disease were included. We extracted the data of relevant information and the results were reported through narrative synthesis and descriptive statistics.
RESULTS: A total of 48 studies were initially identified, and 11 studies were finally included in the review. The mean age of the patients was 25.88 years. Of the 17 patients, 64.7% were men. Symptoms often included abdominal pain, nausea, and vomiting. Most patients were discharged with improved symptoms and liver function. Common bile duct dilation and other findings were observed in imaging results and other diagnostic studies.
CONCLUSIONS: This review highlights the diverse presentations and diagnostic modalities used in ketamine-induced cholangiography. These patients tend to be young men with deranged liver function tests and abdominal pain, which should be taken into consideration. These patients often require a multidisciplinary approach in their management.
摘要：
目的：麻醉师在某些手术中更喜欢氯胺酮，因为它作为脑中N-甲基-D-天冬氨酸受体的非竞争性抑制剂的有效性。最近,这种药物也显示出作为抗抑郁药的前景。然而,氯胺酮可引起致幻作用，有时被滥用为非法药物。氯胺酮滥用与肝脏和胆管并发症有关。这项系统研究旨在通过回顾病例报告更好地了解氯胺酮滥用者的胆管病变。
方法：在这篇系统综述中，对术语“胆道疾病”和“氯胺酮”进行了全面的文献检索。包括有记录的氯胺酮滥用和报告的胆管病变或胆道疾病的成年患者的病例报告和病例系列。我们提取了相关信息的数据，并通过叙事综合和描述性统计将结果报告。
结果：最初确定了总共48项研究，11项研究最终纳入本综述.患者的平均年龄为25.88岁。在17名患者中，64.7%是男性。症状通常包括腹痛，恶心,和呕吐。大多数患者出院，症状和肝功能得到改善。在影像学结果和其他诊断研究中观察到胆总管扩张和其他发现。
结论：这篇综述强调了氯胺酮诱导的胆道造影中使用的不同表现和诊断方式。这些患者往往是肝功能检查异常和腹痛的年轻男性，这是应该考虑的。这些患者通常需要多学科的管理方法。
方法：在这篇系统综述中，对术语“胆道疾病”和“氯胺酮”进行了全面的文献检索。包括有记录的氯胺酮滥用和报告的胆管病变或胆道疾病的成年患者的病例报告和病例系列。我们提取了相关信息的数据，并通过叙事综合和描述性统计将结果报告。
结果：最初确定了总共48项研究，11项研究最终纳入本综述.患者的平均年龄为25.88岁。在17名患者中，64.7%是男性。症状通常包括腹痛，恶心,和呕吐。大多数患者出院，症状和肝功能得到改善。在影像学结果和其他诊断研究中观察到胆总管扩张和其他发现。
结论：这篇综述强调了氯胺酮诱导的胆道造影中使用的不同表现和诊断方式。这些患者往往是肝功能检查异常和腹痛的年轻男性，这是应该考虑的。这些患者通常需要多学科的管理方法。
