Bournet B, Migueres I, Delacroix M, Vigouroux D, Bornet J-L, Escourrou J, Buscail L
Department of Gastroenterology and INSERM U531 (BB, JE, LB), Centre Hospitalier Universitaire Rangueil, Toulouse, France.
Endoscopy. 2006 Apr;38(4):349-54. doi: 10.1055/s-2005-921173.
Endoscopic ultrasonography (EUS) now has an important place in the diagnosis of gastroenteropancreatic diseases. However, prospective data on the morbidity and mortality related to its use are sparse and often retrospective. We attempted to assess the acute and immediate complications of both diagnostic and interventional EUS.
At our university-affiliated tertiary care referral center, immediate (occurring during the procedure) and acute (occurring within 24 hours) complications of EUS were prospectively investigated. Over a first period, spanning 10 years, complications of diagnostic EUS involving 3207 consecutive patients were assessed. During the second period of 3 years, complications observed after EUS-guided fine-needle aspiration (FNA) biopsy were evaluated from 224 procedures. EUS was mostly done with the patient under sedation with intravenous propofol and spontaneous ventilation, and complications were evaluated by both the operator and the anesthesiologist.
There were no deaths, and no surgery was required over the two periods of assessment. Three mild complications occurred among patients who underwent standard diagnostic EUS: two immediate complications were related to anesthesia and one to the procedure. There were five complications associated with interventional EUS; all were related to the procedure (acute pancreatitis, duodenal perforation, upper digestive bleeding, cyst, and mediastinal infection), with a mean delay of occurrence of 30 hours, and mean duration of hospitalization of 7 days.
In our experience, which is the longest reported in Europe, the morbidity rates of diagnostic EUS and EUS-guided FNA biopsy were 0.093% and 2.2%, respectively, with no mortality.
内镜超声检查（EUS）目前在胃肠胰疾病的诊断中占据重要地位。然而，关于其使用相关的发病率和死亡率的前瞻性数据稀少，且多为回顾性研究。我们试图评估诊断性和介入性EUS的急性和即时并发症。
在我们大学附属医院的三级医疗转诊中心，对EUS的即时（检查过程中发生）和急性（24小时内发生）并发症进行了前瞻性研究。在第一个为期10年的时间段内，评估了连续3207例患者的诊断性EUS并发症。在第二个为期3年的时间段内，对224例EUS引导下细针穿刺（FNA）活检后观察到的并发症进行了评估。EUS大多在患者静脉注射丙泊酚镇静并自主呼吸的情况下进行，并发症由操作者和麻醉医师共同评估。
在两个评估时间段内均无死亡病例，也无需进行手术。接受标准诊断性EUS的患者中出现了3例轻度并发症：2例即时并发症与麻醉有关，1例与操作有关。介入性EUS有5例并发症；均与操作有关（急性胰腺炎、十二指肠穿孔、上消化道出血、囊肿和纵隔感染），平均发生延迟为30小时，平均住院时间为7天。
根据我们的经验（欧洲报道的最长经验），诊断性EUS和EUS引导下FNA活检的发病率分别为0.093%和2.2%，无死亡病例。
