Kahaleh Michel, Artifon Everson L A, Perez-Miranda Manuel, Gaidhane Monica, Rondon Carlos, Itoi Takao, Giovannini Marc
Michel Kahaleh, Monica Gaidhane, Carlos Rondon, Division of Gastroenterology and Hepatology, Department of Medicine, Weill Cornell Medical Center, New York, NY 10021, United States.
World J Gastroenterol. 2015 Jan 21;21(3):726-41. doi: 10.3748/wjg.v21.i3.726.
Endoscopic retrograde cholangiopancreatography (ERCP) is the preferred procedure for biliary and pancreatic drainage. While ERCP is successful in about 95% of cases, a small subset of cases are unsuccessful due to altered anatomy, peri-ampullary pathology, or malignant obstruction. Endoscopic ultrasound-guided drainage is a promising technique for biliary, pancreatic and recently gallbladder decompression, which provides multiple advantages over percutaneous or surgical biliary drainage. Multiple retrospective and some prospective studies have shown endoscopic ultrasound-guided drainage to be safe and effective. Based on the currently reported literature, regardless of the approach, the cumulative success rate is 84%-93% with an overall complication rate of 16%-35%. endoscopic ultrasound-guided drainage seems a viable therapeutic modality for failed conventional drainage when performed by highly skilled advanced endoscopists at tertiary centers with expertise in both echo-endoscopy and therapeutic endoscopy.
内镜逆行胰胆管造影术（ERCP）是胆管和胰腺引流的首选方法。虽然ERCP在约95%的病例中取得成功，但一小部分病例因解剖结构改变、壶腹周围病变或恶性梗阻而失败。内镜超声引导下引流是一种有前景的胆管、胰腺及近期胆囊减压技术，与经皮或手术胆管引流相比具有多种优势。多项回顾性研究和一些前瞻性研究表明内镜超声引导下引流安全有效。根据目前报道的文献，无论采用何种方法，累积成功率为84%-93%，总体并发症发生率为16%-35%。当由在三级中心具备超声内镜和治疗内镜专业知识的高技能高级内镜医师进行时，内镜超声引导下引流似乎是传统引流失败时一种可行的治疗方式。
