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内镜超声引导下细针穿刺胰腺囊性病变的并发症:一项大型前瞻性多中心研究的最终结果

Complications of endoscopic ultrasound fine needle aspiration on pancreatic cystic lesions: final results from a large prospective multicenter study.

作者信息

Tarantino Ilaria, Fabbri Carlo, Di Mitri Roberto, Pagano Nico, Barresi Luca, Mocciaro Filippo, Maimone Antonella, Curcio Gabriele, Repici Alessandro, Traina Mario

机构信息

Gastroenterology Department, ISMETT/UPMC (Mediterranean Institute for Transplantation and Advanced Specialized Therapies/University of Pittsburgh Medical Center in Italy), Palermo, Italy.

Gastroenterology Department, AUSL Bologna, Bellaria-Maggiore Hospital, Bologna, Italy.

出版信息

Dig Liver Dis. 2014 Jan;46(1):41-4. doi: 10.1016/j.dld.2013.08.134. Epub 2013 Sep 17.

Abstract

BACKGROUND

Endoscopic ultrasound-guided fine needle aspiration of pancreatic cystic lesions has been reported to have a higher complication rate than that of solid lesions, but the real complication rate is unknown. Aim of the study was to identify the complication rate of endoscopic ultrasound-guided fine needle aspiration and related risk factors.

METHODS

Prospective multicenter study at four referral centres. Data were collected from January 2010 to July 2012, searching for all adverse events related to guided fine needle aspiration. All complications occurring up to day 90 were recorded.

RESULTS

298 patients (43.9% male, mean age 63.2 ± 15.4 years) underwent endoscopic ultrasound-guided needle aspiration of pancreatic cystic lesions. Mean size was 34.1 ± 9 mm. Adverse events occurred in 18 patients (6%): mild complications in 12/18 (66.6%), and moderate complications in 6/18 (33.3%). Seven were immediate, 6 early, and 5 late. All resolved with medical therapy.

CONCLUSIONS

Endoscopic ultrasound-guided fine needle aspiration of pancreatic cystic lesions has been found to be associated with a higher complication rate than for solid lesions; however, the risk rate is acceptable considering the complication grade and the important diagnostic role of the technique in the management of pancreatic cystic lesions.

摘要

背景

据报道,内镜超声引导下胰腺囊性病变细针穿刺活检的并发症发生率高于实性病变,但实际并发症发生率尚不清楚。本研究的目的是确定内镜超声引导下细针穿刺活检的并发症发生率及相关危险因素。

方法

在四个转诊中心进行前瞻性多中心研究。收集2010年1月至2012年7月的数据,寻找与引导性细针穿刺活检相关的所有不良事件。记录至第90天发生的所有并发症。

结果

298例患者(男性占43.9%,平均年龄63.2±15.4岁)接受了内镜超声引导下胰腺囊性病变细针穿刺活检。平均大小为34.1±9mm。18例患者(6%)发生不良事件:12/18例(66.6%)为轻度并发症,6/18例(33.3%)为中度并发症。7例为即刻并发症,6例为早期并发症,5例为晚期并发症。所有并发症均经药物治疗后缓解。

结论

内镜超声引导下胰腺囊性病变细针穿刺活检的并发症发生率高于实性病变;然而,考虑到并发症等级以及该技术在胰腺囊性病变管理中的重要诊断作用,风险率是可以接受的。

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