内镜超声波在急性胆囊炎的管理:实践审查
Mihai Rimbaş1,2, Giulia Tripodi3, Gianenrico Rizzatti3
1Gastroenterology Department, Colentina Clinical Hospital, Bucharest, Romania.
概括
在高风险患者中,内镜超声引导胆囊排水 (EUS-GBD) 是急性胆囊炎的皮肤通排水的更安全的替代方案. 需要进一步的研究来比较EUS-GBD与腹腔镜胆囊切除术.
科学领域:
- 胃肠病学 胃肠病学
- 干预性内镜检查是干预性的内镜检查.
- 手术风险评估手术风险评估
背景情况:
- 高手术风险患者的急性胆囊炎 (AC) 是一个临床挑战.
- 穿皮排水 (PT-GBD) 是一种传统的方法.
- 腹腔镜胆囊切除术 (LC) 是黄金标准,但对这些患者有风险.
研究的目的:
- 评估内镜超声波引导胆囊排水 (EUS-GBD) 作为PT-GBD的替代方案.
- 评估EUS-GBD在高手术风险AC患者的疗效和安全性.
- 探索EUS-GBD在胆囊切除术患者中的潜在作用.
主要方法:
- 综述了比较EUS-GBD和PT-GBD的研究和元分析.
- 分析LAMS对EUS-GBD程序的影响.
- 讨论EUS-GBD在替代手术场景中的理论应用.
主要成果:
- 在高手术风险的AC患者中,EUS-GBD显示出优于PT-GBD的优势.
- LAMS已经提高了EUS-GBD的易用性和安全性.
- 有限的证据直接将EUS-GBD与腹腔镜胆囊切除术进行比较.
结论:
- 对于高风险的AC,EUS-GBD是PT-GBD的有效和更安全的替代方案.
- 与LC相比,EUS-GBD的作用需要进一步调查.
- 对于某些患有胆囊切除术指示或高转化风险的患者来说,EUS-GBD可能是一个有价值的选择.
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