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内镜超声引导下胰十二指肠切除术后早期经胃引流术后积液的有效性和可行性

The Effectiveness and Feasibility of Endoscopic Ultrasound-guided Transgastric Drainage of Postoperative Fluid Collections Early After Pancreatic Surgery.

作者信息

Futagawa Yasuro, Imazu Hiroo, Mori Naoki, Kanazawa Keisuke, Chiba Masafumi, Furukawa Kenei, Sakamoto Taro, Shiba Hiroaki, Yanaga Katsuhiko

机构信息

Departments of *Surgery †Endoscopy, The Jikei University School of Medicine, Tokyo, Japan.

出版信息

Surg Laparosc Endosc Percutan Tech. 2017 Aug;27(4):267-272. doi: 10.1097/SLE.0000000000000413.

DOI:10.1097/SLE.0000000000000413
PMID:28520649
Abstract

PURPOSES

To assess the feasibility and usefulness of endoscopic ultrasound-guided transgastric drainage (EUS-GD) in patients who required early postoperative drainage of peripancreatic fluid collection or postoperative pancreatic fistulas after pancreatic surgery.

PATIENTS AND METHODS

Between May 2012 and January 2016, 33 patients who developed peripancreatic fluid collection or postoperative pancreatic fistulas after pancreatic resection underwent EUS-GD or percutaneous drainage (PTD). Outcomes were compared retrospectively.

RESULTS

The drainage procedures were performed on postoperative day 4 to 71 (median, 12) in the EUS-GD group, and 7 to 35 (median, 14) in the PTD group. Technical and clinical success rates reached 92% (11/12) in the EUS-GD group, and 100% (21/21) in the PTD group with no complications or mortality. The duration of hospital stay after drainage was 10 to 44 (median, 15) days for EUS-GD, compared with 10 to 39 (median, 21) days for PTD.

CONCLUSIONS

EUS-GD is a safe and useful method for early drainage, which could be a good alternative to PTD.

摘要

目的

评估内镜超声引导下经胃引流术(EUS-GD)在胰腺手术后需要早期引流胰周积液或术后胰瘘患者中的可行性和实用性。

患者与方法

2012年5月至2016年1月期间,33例胰腺切除术后出现胰周积液或术后胰瘘的患者接受了EUS-GD或经皮引流(PTD)。对结果进行回顾性比较。

结果

EUS-GD组在术后第4至71天(中位数为12天)进行引流操作,PTD组在术后第7至35天(中位数为14天)进行引流操作。EUS-GD组的技术成功率和临床成功率达到92%(11/12),PTD组为100%(21/21),且无并发症或死亡。EUS-GD组引流后的住院时间为10至44天(中位数为15天),而PTD组为10至39天(中位数为21天)。

结论

EUS-GD是一种安全有效的早期引流方法,可作为PTD的良好替代方案。

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