遵守ESGE关于胆汁支架在恶性远端狭窄的指导方针:来自意大利未来注册的结果
Tommaso Schepis1, Rocco Maurizio Zagari2, Stefano Francesco Crinó3
1Digestive Endoscopy Unit, Fondazione Policlinico Gemelli IRCCS - Catholic University, Rome, Italy.
Endoscopy international open
|February 18, 2026
概括
意大利内镜中心对管理远端恶性胆道狭窄症 (dMBS) 的指导方针的遵守情况有所变化. 在内镜逆行胆血管瘤学 (ERCP) 期间,在支架选择,病理诊断和预防措施方面需要改进.
科学领域:
- 胃肠病学 胃肠病学
- 内镜检查是指内镜检查.
- 胆汁干预 胆汁干预
背景情况:
- 远端恶性胆道狭窄 (dMBS) 是内镜逆向胆道细胞造影 (ERCP) 的常见原因.
- 在管理dMBS时,评估遵守欧洲胃肠内镜学会 (ESGE) 准则对于优化患者护理至关重要.
- 意大利内镜中心的做法是根据已建立的ESGE建议进行评估的.
研究的目的:
- 评估意大利内镜中心是否遵守ESGE关于dMBS管理的指南.
- 确定遵守指导方针需要改进的具体领域.
- 为改善dMBS管理中的临床实践和患者结果提供数据.
主要方法:
- 一项前性,观察性,多中心研究,涉及17个意大利内镜中心.
- 包括827名在2020年1月至2022年1月期间被诊断患有dMBS的连续患者.
- 基于八个ESGE建议的遵守评估,分为完整,中等或差.
主要成果:
- 在ERCP后的急性胰腺炎预防,再治疗和手术前胆汁排水中观察到完全遵守.
- 在选择息性排水支架 (85%的SEMS,15%的塑料支架) 时,观察到中间的坚持.
- 在手术前排水支架类型 (56%的SEMS),U-SEMS安置的病理诊断 (45%没有诊断),抗生素预防 (70.6%) 和膜切除 (88%) 中报告了不良坚持.
结论:
- 遵守dMBS管理的ESGE指南需要在几个关键领域进行改进.
- 需要特别关注减少过度使用塑料支架,并在安装U-SEMS之前确保病理诊断.
- 常规的抗生素预防和缩切除术实践需要重新评估,以与当前的指导方针保持一致.
相关概念视频
Esophageal Strictures-I: Introduction
933
Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
933
Esophageal Strictures-II: Clinical Features and Management
723
Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
723
Esophageal Varices-II: Clinical Features and Management
641
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
641
Endoscopic Procedures V: ERCP
4.0K
Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...
Patient...
4.0K
Barrett Esophagus-II: Clinical Manifestations and Management
1.2K
Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
1.2K


