内镜超声导向的胰腺管道排水
Judy A Trieu1, Gulseren Seven2, Todd H Baron3
1Division of Gastroenterology, Washington University in St. Louis, 660 South Euclid Avenue, MSC 8124-21-427, St Louis, MO 63110, USA. Electronic address: https://twitter.com/TrieuMD.
Gastrointestinal endoscopy clinics of North America
|May 25, 2024
概括
在标准方法失败时,内镜超声导向胰腺管道排水 (EUS-PDD) 提供了解决方案,特别是对于非手术患者. 这种技术,包括EUS辅助的胰腺聚会和EUS指导的胰腺胃口术,表现出很高的成功,但存在风险.
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.
- 手术解剖学手术解剖学
背景情况:
- 胰腺管道 (PD) 排水非常重要,当乳头或解无法进入时,特别是对于不适合进行手术的患者.
- 在这种具有挑战性的情况下,内镜超声导向胰腺管道排水 (EUS-PDD) 提供了一种替代方法.
- 目前有两种主要的EUS-PDD技术:EUS辅助的胰腺聚会 (EUS-PRV) 和EUS指导的胰腺胃口术 (EUS-PG).
研究的目的:
- 审查EUS-PDD的技术,成果和考虑.
- 为了比较EUS-PRV和EUS-PG在不同解剖场景中的适用性.
- 突出多学科方法在PD排水管理中的重要性.
主要方法:
- 审查EUS-PDD技术,包括EUS-PRV和EUS-PG.
- 在文献中报告的技术和临床成功率的分析.
- 讨论不良事件概况和患者选择标准.
主要成果:
- 对于EUS-PDD的技术和临床成功率在79%至100%之间广泛而有所不同.
- 与EUS-PDD相关的不良事件发生在约20%的病例中.
- EUS-PRV适用于可访问的乳头/解剖,而EUS-PG对改变的前肠解剖有效.
结论:
- 当传统方法不可行时,EUS-PDD是胰腺管道减压的可行选择.
- 患者特定的因素,包括解剖学和临床目标,决定了EUS-PRV和EUS-PG之间的选择.
- 胃肠道学,外科和干预放射学之间的合作决策对于最佳的患者管理至关重要.
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