在LAMS内对同轴双尾支架在胰腺液体收集管理中的批判性叙述审查
Giuseppe Infantino1, Gabriele Rancatore1, Dario Quintini1
1Gastroenterology and Endoscopy Unit, IRCCS ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), University of Pittsburgh Medical Center Italy (UPMCI), CAP 90127 Palermo, Italy.
Medicina (Kaunas, Lithuania)
|August 28, 2025
概括
在胰腺流体采集中,使用光体施加金属支架 (LAMS) 进行内超声导排水是标准的. 通过减少感染和复发等并发症,添加双猪尾塑料支架 (DPPS) 可能有利于高风险患者.
科学领域:
- 胃肠病学
- 干预性内镜
背景情况:
- 使用膜附着金属支架 (LAMS) 进行内超声波 (EUS) 引导的排水是管理胰腺液体收集 (PFC) 的标准,特别是隔壁性瘤 (WON).
- 这些LAMS携带诸如出血,封闭和感染等不良事件的风险.
研究的目的:
- 批判性地审查使用同轴双尾塑料支架 (DPPS) 在LAMS中用于EUS引导的PFC排水的综合方法的证据.
- 在特定患者群体中探索这种联合技术的潜在益处和风险.
主要方法:
- 追溯和前性研究的叙述性审查,一个随机对照试验 (RCT) 和元分析.
- 对LAMS特有的不良事件和同轴DPPS放置的影响进行检查.
主要成果:
- 在LAMS中不建议常规使用同轴DPPS.
- 新出现的数据表明,在高风险情况下 (例如,大WON,富有碎片的腔,脱节的胰腺管综合征) 通过减少闭塞,感染和复发而有好处.
- 与热AXIOS支架相比,SPAXUS支架显示出较低的出血和迁移率.
结论:
- 建议针对患者量身定制的方法和实用算法用于LAMS中的同轴DPPS.
- 需要技术创新和进一步的高质量研究来确定同轴DPPS在EUS引导PFC排水中的最佳作用.
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