预先内镜性瘤切除术或感染性缩性胰腺炎 (DESTIN) 的逐步内镜方法:单盲,多中心,随机试验
Ji Young Bang1, Sundeep Lakhtakia2, Shyam Thakkar3
1Digestive Health Institute, Orlando Health, Orlando, FL, USA.
The lancet. Gastroenterology & hepatology
|November 19, 2023
概括
对于感染性缩性胰腺炎的前端内镜性切术,与逐步方法相比,显著减少了重新干预. 这种策略对稳定患者具有隔墙性瘤是安全有效的.
科学领域:
- 胃肠病学 胃肠病学
- 手术创新 在外科创新.
- 临床试验 临床试验
背景情况:
- 感染性瘤性胰腺炎的管理通常涉及内镜透光支架和瘤切除术.
- 死体切除术的最佳时间尚不清楚,这促使对前期与逐步方法进行调查.
研究的目的:
- 为了比较前期内镜性瘤切除术的结果与感染瘤性胰腺炎患者的逐步治疗方法.
主要方法:
- 一个多中心,单盲,随机试验 (DESTIN) 招募了70名感染死炎的患者.
- 患者被随机分配到前期内镜内切除术或逐步升级的治疗策略.
- 主要结局是需要在6个月内实现治疗成功的重复干预次数.
主要成果:
- 预先切除组 (1) 的中位数重新干预的数量明显低于步骤升级组 (2) (p=0·0027).
- 死亡率和总体疾病相关或程序相关的不良事件在两组之间没有显著差异.
结论:
- 在已稳定患有感染瘤性胰腺炎和封装采集的患者中,前端内镜性瘤切除术可以安全地减少重新干预的数量.
- 这种方法为这种情况提供了一个潜在的更有效的治疗策略.
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