Chapman Christopher G, Waxman Irving, Siddiqui Uzma D
Center for Endoscopic Research and Therapeutics (CERT), University of Chicago Medicine, Chicago, IL, USA.
Clin Endosc. 2016 Mar;49(2):161-7. doi: 10.5946/ce.2016.011. Epub 2016 Mar 25.
Despite the advances in endoscopy, endoscopic ultrasound-guided pancreatic duct drainage (EUS-PDD) remains a technically challenging procedure. Technical success rates are greater than 70%; however, the average rate of adverse events is nearly 20%, which increases to 55% when stent migration is included. Until recently, a significant difficulty with this technique was the absence of dedicated devices. Proper patient selection is of utmost importance, and EUS-PDD should be reserved for patients who have failed endoscopic retrograde pancreatography. Furthermore, EUS-PDD must be performed by experienced endoscopists who are familiar with the technique. The most common indications include chronic pancreatitis induced strictures and stones, disconnected pancreatic ducts, inaccessible ampulla, and post-surgical altered anatomy. This manuscript will review the accessories used, techniques employed, and published literature reporting outcomes as well as adverse events regarding EUS-PDD.
尽管内镜检查技术有所进步，但内镜超声引导下胰管引流术（EUS-PDD）仍是一项技术要求很高的操作。技术成功率超过70%；然而，不良事件的平均发生率接近20%，若将支架移位包括在内，则升至55%。直到最近，这项技术的一个重大困难是缺乏专用设备。正确选择患者至关重要，EUS-PDD应仅用于内镜逆行胰胆管造影失败的患者。此外，EUS-PDD必须由熟悉该技术的经验丰富的内镜医师进行操作。最常见的适应证包括慢性胰腺炎引起的狭窄和结石、胰腺导管离断、壶腹难以接近以及手术后解剖结构改变。本文将回顾EUS-PDD所使用的附件、采用的技术以及报告结果和不良事件的已发表文献。
