Page 67 - Magyar Gasztroenterológiai Társaság 2020. november 6–7. – ONLINE KONGRESSZUS

Előadáskivonatok / Abstracts

started for 8/46(17.4%) patients. Deviation from guidelines in 1. Institute for Translational Medicine, Szentágothai
both IVF therapy and feeding recommendations did not Research Centre, Medical School, University of Pécs,
deteriorate the course of APP (p=0.297), but significantly Hungary; 2. Division of Gastroenterology, First Department
increased the length of hospitalization(LOH) (14.8±5.6 days of Medicine, Medical School, University of Pécs, Pécs,
vs 26.2±4.4 days, p=0.034). Half of the patients received Hungary; 3. Szent György University Teaching Hospital of
antibiotic therapy(AB). There were no difference in severity Fejér County, Székesfehérvár, Hungary; 4. Institute of
between patients who received AB for prevention (14/23, Bioanalysis, Medical School, University of Pécs, Pécs,
30%) and either those who were treated with AB for Hungary; 5. 1st Department of Medicine, University of
infection(9/23, 39.1%,p=0.64) or those who did not get Szeged, Szeged, Hungary; 6. County Emergency Clinical
AB(23/46, 50%,p=0.65). Preventive AB treatment was Hospital Târgu Mures; George Emil Palade University of
associated with significantly longer LOH. Medicine, Pharmacy, Sciences and Technology of Târgu
Conclusion: The results highlight that the evidence-based Mureș, Romania; 7. Department of Internal Medicine,
EPC/HPSG guidelines should be followed strictly in order to Division of Gastroenterology, University of Debrecen,
reduce the length of hospitalization in APP. Debrecen, Hungary; 8. Dr. Bugyi István Hospital, Szentes,
Hungary; 9. Bajcsy-Zsilinszky Hospital, Budapest, Hungary;
85. FIRST COMMON BILE DUCT STONE REMOVAL BY 10. Heim Pál National Institute for Pediatrics, Budapest,
SPYGLASS GUIDED ELECTROHYDRAULIC Hungary; 11. Centre for Translational Medicine, 1st
LITHOTRIPSY (EHL) IN HUNGARY Department of Medicine, University of Szeged, Szeged,
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Liebe R. , Molnár E. , Czakó L. , Tari K. , Bíró P. , Mészáros Hungary; 12. Division of Translational Medicine, First
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B. , Ácsné Tóth A. , Kovács I. , Rácz S. , Sahin P. Department of Medicine, Medical School, University of Pécs,
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1. Department of Gastroenterology, Jahn Ferenc Dél-pesti Pécs, Hungary; 13. Hungarian Academy of Sciences -
Hospital, Budapest, Hungary; 2. 1st Department of Internal University of Szeged, Momentum Gastroenterology
Medicine, University of Szeged, Szeged, Hungary Multidisciplinary Research Group, Szeged, Hungary; 14. on
behalf of the Hungarian Pancreatic Study Group
Introduction: SpyGlass Direct Visualization System is a
single-operator peroral cholangioscopy technique that Introduction: Disturbance of consciousness (DOC) may
provides direct visualization of biliary ducts. SpyGlass can be develop in acute pancreatitis (AP). In clinical practice, it is
used for both diagnostic and therapeutic purposes in known that DOC may worsen the patient’s condition.
biliopancreatic diseases. Treatment of difficult bile duct Aims: There is no exact data on how DOC affects the
stones by SpyGlass guided EHL has not been attempted in outcome of AP, our aim was to show associations between
Hungary before. DOC and AP.
Methods: From the Hungarian Pancreatic Study Groups’ AP
Aims: Our aim is to present the first case of SpyGlass guided registry, 1220 cases contained the exact data on DOC.
EHL in Hungary (with video demonstration) and to draw Patients were separated to Non-DOC and DOC, whereas
attention to its relevance in the treatment of bile duct stones. DOC was further divided into non-alcohol related DOC (Non-
Case description: We present the case of an 83-year-old ALC DOC) and ALC-DOC groups. Statistical analysis was
female patient who had previously undergone five ERCP performed by SPSS 24 Software Package.
procedures due to multiple bile duct stones. Unfortunately, Results: From the 1220 patients, 47 (3.85%) developed
the stones could not have been removed by conventional DOC, 23 (48.9%) cases were ALC DOC vs. 24 (51.1%) Non-
endoscopic techniques due to moderate benign distal ALC DOC. The incidence of severe AP was higher in the
common bile duct stenosis. Therefore, we decided to remove DOC compared to the Non-DOC group (19.15% vs. 5.29%,
the stones by SpyGlass guided EHL for the first time in p<0.001). The mortality was higher in the DOC vs. Non-DOC
Hungary. During the initial cholangiography, 5 stones (10- group (14.89% vs. 1.71%, p<0.001). Length of
14mm) were detected in the common bile duct. After hospitalization (LOH) was longer in the DOC vs. non-DOC
extracting some of the stones by mechanical lithotripsy, we group (Me:11; IQR:8-17 days vs. Me:9; IQR:6-13 days,
achieved direct visualization of the remaining biliary stones p=0.049). Patients with ALC DOC developed more frequently
by SpyGlass system. We managed to target and break them moderately-severe AP vs. Non-ALC DOC (43.48% vs.
by EHL, then stone fragments and smaller stones were 12.5%), while the incidence of severe AP was significantly
removed by balloon and Dormia basket. Post-procedural higher in Non-ALC vs. ALC DOC group (33.33% vs. 4.35%)
acute cholangitis was detected which is the most common (p<0.001). LOH showed tendency to be longer in Non-ALC
adverse event related to SpyGlass examinations. The patient DOC compared to ALC DOC respectively (Me:13; IQR:7-20
fully recovered. days vs. Me:9.5; IQR:8-15.5 days, p=0.119).
Conclusion: DOC during AP is associated with a higher rate
Conclusion: SpyGlass guided EHL is an effective treatment of moderate and severe AP and increases the risk of
of difficult bile duct stones refractory to conventional therapy. mortality; therefore, the DOC should be closely monitored
The first procedure in Hungary was successful, however, and prevented in AP
further experience is needed.
87. FREQUENCY OF SEVERE COMPLICATIONS IN
86. DISTURBANCE OF CONSCIOUSNESS DIABETIC AND NON-DIABETIC CHRONIC HEPATITIS C
DETERIORATES THE SEVERITY OF ACUTE PATIENTS USING MATCHED-PAIR ANALYSIS.
PANCREATITIS. AN INTERNATIONAL MULTICENTRE RESULTS OF A COMPARATIVE STUDY FROM A NORTH-
COHORT ANALYSES OF 1220 PROSPECTIVELY EAST HUNGARIAN REGION
COLLECTED PATIENTS Lombay B. , Szalay F.
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Lillik V. , Vincze Á. , Izbéki F. , Gajdán L. , Gódi S. , Illés A. , 1. Department of Gastroenterology, Borsod County Central
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Sarlós P. , Farkas N. , Erőss B. , Hágendorn R. 1,11 , Illés Teaching Hospital, Miskolc; 2. Clinic of Internal Medicine and
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D. , Varjú P. , Márta K. , Török I. , Papp M. , Vitális Z. , Bod Oncology, Semmelweis University, Budapest
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B. , Hamvas J. , Szepes Z. , Takács T. , Czakó L. , Szentesi
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A. , Párniczky A. 1,10,11 , Hegyi P. 1,12,13,14 , Mikó A. 1,2,11
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Central European Journal of Gastroenterology and Hepatology 65
Volume 6, Supplementum 2 / November 2020