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담관 폐쇄 환자에서 담도압 상승과 관련이 있는 임상 지표
이종균(Jong Kyun Lee),이풍렬(Poong Lyul Rhee),김재준(Jae Jun Kim),고광철(Kwang Cheol Koh),백승운(Seung Woon Paik),이종철(Jong Chul Rhee),주성욱(Seong Wook Choo),주인욱(In Wook Choo) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.3
N/A Background/Aims: Increased bile duct pressure is the major factor responsible for acute cholangi- tis and bacteremia. Therefore, prompt medical or surgical decompression of bile under high pressure should be accomplished as fast as possible. But, measuretnent of bile duct pressure is invasive. So, the present study was undertaken to find out the clinical factors to predict the increased biliary pressure in patients with bile duct obstruction. Methods: Thirty-three patients with bile duct obstruction underwent percutaneous transhepatic biliary drainage(PTBD). Intraductal pressure was measured as soon as bile duct pucture was performed. Bile cultures were performed in 24 patients and blood cultures were performed in 21 patients. Correlation of bile duct pressure and severity of pain, duration of symptom, fever, leukocytosis, serum bilirubin, serurn alkaline phosphatase, or bile duct diameter were statistically analyzed. Results: Bacteremias were noticed in 5 of the 17 patients with positive bile culture. Bacteremia was associated with the increased biliary pressure. Bacteremia was demonstrated when the biliary pressure was 22 cmHyO or more. Biliary pressure was associated with the severity of pain and body temperature. Significant correla- tion was not found between the duration of symptom, leukocytosis, serum bilirubin, serum alkaline phosphatase, or bile duct diameter and biliary pressure. Conclusions: Increased biliary pressure in patients with bile duct obstruction is more likely to be associated with severity of pain and fever than leukocytosis, bilirubin level, alkaline phosphatase level, or bile duct diameter. (Korean J Gastroenterol 1996; 28:409 - 414)
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