用内镜超声导向胰腺囊切除的短期结果:系统性审查和元分析
Ahmed Al Qady1,2, Kapil Dev Nayar3, Fatima Elmustafa4
1Division of Gastroenterology, Hepatology and Nutrition, University of Florida, Gainesville, Florida.
Gastro hep advances
|February 25, 2025
概括
内镜超声导向切除为管理胰腺囊 (PCs) 提供了可行的替代方案,显示了中度的完全解脱率. 将切除与化疗切除剂相结合,可以提高PC的治疗效果.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 医疗成像医学成像
背景情况:
- 胰腺囊 (PCs) 越来越多地通过腹部成像检测到.
- 对PC的手术带来风险和高成本,需要替代治疗.
- 以内镜超声波引导的PC切除正在作为一种不那么侵入性的选择进行探索.
研究的目的:
- 系统地审查和元分析内镜超声波引导PC切除的短期疗效.
- 评估与这种PC管理技术相关的并发症率.
主要方法:
- 对PubMed,Ovid,Cochrane和TRIP的研究进行了系统审查和元分析.
- 主要结局:囊解脱 (完全/部分) 和在去除后12个月的持续性.
- 二次结果:评估与程序相关的不良事件.
主要成果:
- 在50%的病例中观察到囊完全消失;在27%的病例中观察到部分消失;在17%的病例中观察到持续性.
- 解析速率因废弃剂而异:乙醇 (29%),劳罗马克罗戈尔 (51%),乙醇/帕克利塔克塞尔 (63%),帕克利塔克塞尔/杰米卡丁 (67%),乙醇/帕克利塔克塞尔/杰米卡丁 (61%).
- 副作用不常见:腹痛 (4%),胰腺炎 (3%) 和发烧 (1%).
结论:
- 以内镜超声波引导的切除可为胰腺囊提供可接受的完整解决方案.
- 严重不良事件的发生率很低.
- 化学消耗剂显著提高了PC的内镜超声波导向消耗的有效性.
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