Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
Gastroenterol Res Pract. 2012;2012:680753. doi: 10.1155/2012/680753. Epub 2012 May 10.
Background and Aim. EUS-guided intervention (EGI) for biliary therapy has been increasingly used in recent years. This report aims to describe the spectrum and experience of EUS-guided interventions in biliary diseases in a single-tertiary center. Methods. All patients with EGI were analyzed retrospectively by retrieving data from a prospectively stored endoscopic database between January 2006 and September 2010. Results. There were 31 cases with EGIs (17 female, 14 male) with a mean age ± SD of 58.03 ± 16.89 years. The majority of cases (17/31; 55%) were ampullary or pancreatic cancers with obstructive jaundice. The major indications for EGI were obstructive jaundice (n = 16) and cholangitis (n = 9). The EGIs were technically successful in 24 of the 31 cases (77%). The success rate for the first 3 years was 8 of 13 procedures (61.5%) as compared to that of the last 2 years (16/18 procedures (89%); P = 0.072). Twenty-three of the 24 cases (96%) with technical success for stent placement also had clinical success in terms of symptom improvement. The complications were major in 4 (13%) and minor in 7 (23%) patients. Conclusion. The EUS-guided drainage for biliary obstruction, acute cholecystitis, bile leak, and biloma was an attractive alternative and should be handled in expert centers.
近年来,超声内镜引导下的介入治疗(EUS-GI)在胆道治疗中的应用越来越广泛。本研究旨在描述单中心胆道疾病 EUS-GI 的适应证谱和经验。
通过检索 2006 年 1 月至 2010 年 9 月期间前瞻性储存的内镜数据库中的数据,对所有接受 EGI 的患者进行回顾性分析。
共 31 例患者接受了 EGI(17 例女性,14 例男性),平均年龄 ± SD 为 58.03 ± 16.89 岁。大多数病例(17/31;55%)为壶腹或胰腺恶性肿瘤导致的梗阻性黄疸。EUS-GI 的主要适应证为梗阻性黄疸(n = 16)和胆管炎(n = 9)。31 例患者中有 24 例(77%)技术上获得成功。前 3 年的成功率为 13 例中的 8 例(61.5%),而最后 2 年的成功率为 18 例中的 16 例(89%)(P = 0.072)。24 例技术成功放置支架的患者中,23 例(96%)的临床症状也得到改善。并发症发生率为 4 例(13%)为严重并发症,7 例(23%)为轻微并发症。
EUS-GI 用于胆道梗阻、急性胆囊炎、胆漏和胆汁瘤的引流是一种有吸引力的选择,应在专家中心进行处理。