■肝胆筋膜病有两个阶段,每个都需要特定的管理方法。三氯多巴唑已广泛有效地治疗了临床筋膜结石和胆道期内镜逆行胰胆管造影术(ERCP)的两个阶段。我们旨在描述肝胆筋膜瘤的表现,并强调ERCP在治疗中的作用。
■该回顾性队列包括2013年1月至2022年12月期间诊断为临床肝胆筋膜病的患者。人口统计数据,临床表现,实验室和放射学调查,治疗,从62例参与者的记录中收集内窥镜检查报告.患者分为两组:急性肝期和慢性胆道期。
■36名患者处于胆道期,26人处于肝期。所有患者都来自农村地区,女性占主导地位(76%)。在92%的急性病例和58%的慢性胆道病例中检测到嗜酸性粒细胞增多。在慢性胆道病例中,肝脏生化物质的水平,包括丙氨酸转氨酶(ALT),天冬氨酸转氨酶(AST),γ-谷氨酰转移酶(GGT),和胆红素,分别在189±76、127±47、268±77和2.4±0.7的水平较高,与急性肝病例相比,35.6±8.2、32.7±4.3、69.2±45.45和0.58±0.01。相应的P值分别为0.003、0.001、<0.001和<0.001。三氯多唑可有效治愈93.5%的患者,并在34例(94.4%)的胆道系统中从胆道系统中抽出吸虫的胆道期病例中与ERCP联合使用。3例(8.8%)被诊断为ERCP术后胰腺炎。没有一个病人出血,穿孔,或需要胆道支架置入术.
■临床筋膜吸收症可表现为急性肝期或慢性胆道期。嗜酸粒细胞增多在肝期更为明显,而ALT,AST,GGT,胆汁期胆红素较高。三氯多唑在肝期有效,在胆期与ERCP联合有效。ERCP对解除胆道梗阻和治疗胆道筋膜积是非常有效的。
UNASSIGNED: Hepatobiliary fascioliasis has two phases, each requiring specific management approaches. Triclabendazole has been widely effective in treating the two phases of clinical fascioliasis and endoscopic retrograde cholangiopancreatography (ERCP) in the biliary phase. We aimed to characterize presentations of hepatobiliary fascioliasis and highlight the role of ERCP in management.
UNASSIGNED: This retrospective cohort includes patients diagnosed with clinical hepatobiliary fascioliasis between January 2013 and December 2022. Demographic data, clinical presentation, laboratory and radiological investigations, treatment, and endoscopy reports were collected from the records of 62 participants. Patients were divided into two groups: acute hepatic and chronic biliary phases.
UNASSIGNED: Thirty-six patients were in the biliary phase, and 26 were in the hepatic phase. All patients were from rural areas, and females were predominant (76%). Hypereosinophilia was detected in 92% of acute cases and 58% of chronic biliary cases. In chronic biliary cases, the levels of liver biochemicals, including alanine transaminase (ALT), aspartate aminotransferase (AST), gamma-glutamyltransferase (GGT), and bilirubin, were higher at levels of 189 ± 76, 127 ± 47, 268 ± 77, and 2.4 ± 0.7 respectively, compared to acute hepatic cases, 35.6 ± 8.2, 32.7 ± 4.3, 69.2 ± 45.45, and 0.58 ± 0.01. The corresponding P-values were 0.003, 0.001, <0.001, and <0.001, respectively. Triclabendazole effectively cured 93.5% of patients and was used in combination with ERCP in biliary-phase cases where the fluke was extracted from the biliary system in 34 patients (94.4%). Three patients (8.8%) were diagnosed with post-ERCP pancreatitis. None of the patients experienced bleeding, perforation, or required biliary stenting.
UNASSIGNED: Clinical fascioliasis could manifest in acute hepatic or chronic biliary phases. Hypereosinophilia was more evident in the hepatic phases, while ALT, AST, GGT, and bilirubin were higher in the biliary phase. Triclabendazole is effective in the hepatic phase and when combined with ERCP in the biliary phase. ERCP is highly effective for relieving obstruction and treating biliary fascioliasis.