胰腺手术后的液体收集排水和急性胰腺炎:相似但不同?
Yousuke Nakai1,2, Saburo Matsubara3, Tsuyoshi Mukai4
1Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Clinical endoscopy
|May 17, 2024
概括
手术后胰腺 (POPF) 需要量身定制的管理,不同于胰腺液收集 (PFC). 对POPF和术后液体采集 (POPFC) 的内超声学引导排水 (EUS-D) 策略需要进一步澄清.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 干预性内镜检查是干预性的内镜检查.
背景情况:
- 手术后胰腺 (POPF) 是胰腺手术后的常见并发症.
- 对POPF的管理策略,特别是那些没有流体收集 (术后流体收集 - POPFCs) 的管理策略,尚未明确定义.
- 对于急性胰腺炎的胰腺液收集 (PFC) 的现有治疗方法可能不直接适用于POPF.
研究的目的:
- 为了比较POPFs和POPFCs与急性胰腺炎PFCs的管理.
- 根据POPF特征突出修改内镜超声波导向排水 (EUS-D) 策略的需要.
- 确定POPF和POPFC治疗的知识差距和未来研究方向.
主要方法:
- 对当前文学进行比较,将POPF/POPFC管理与PFC管理进行比较.
- 分析影响EUS-D策略的因素,包括流体采集存在,排水状态和外科手术方法.
- 在POPF病例中讨论EUS-D的适应症,时间和支架选择.
主要成果:
- 由于流体收集和手术排水存在的变化,POPF管理需要调整.
- 对于POPFs,EUS-D的指示,时间和支架选择不如PFCs那么成熟.
- POPFs的异质性需要个性化的治疗方法.
结论:
- 与PFC相比,有效地管理POPF和POPFC需要不同的策略.
- 进一步的研究对于阐明各种POPF呈现的最佳EUS-D干预措施至关重要.
- 需要对POPF管理制定标准指导方针,以改善患者的治疗结果.
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