Teoh Anthony Yuen-Bun, Seo Dong Wan, Brugge William, Dewitt John, Kongkam Pradermchai, Linghu Enqiang, Moyer Matthew T, Ryu Ji Kon, Ho Khek Yu
Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
Department of Gastroenterology, Asan Medical Centre, Seoul, Korea.
Endosc Int Open. 2019 Sep;7(9):E1064-E1077. doi: 10.1055/a-0959-5870. Epub 2019 Aug 29.
Recently, several guidelines with divergent recommendations on management of pancreatic cystic neoplasm have been published but the role of endoscopic ultrasound (EUS)-guided pancreatic cyst ablation has not been thoroughly addressed. The aim of the current paper is to explore the issues surrounding EUS-guided pancreatic cyst ablation by generating a list of clinical questions and providing answers based on best scientific evidence available. An expert panel in EUS-guided pancreatic cyst ablation was recruited from members of the Asian EUS group and an international expert panel. A list of clinical questions was created and each question allocated to one member to generate a statement in response. The statements were then discussed in three Internet conference meetings between October 2016 and October 2017. The statements were changed until consensus was obtained. Afterwards, the complete set of statements was sent to all the panelist to vote on strength of the statements, classification of the statement sand grading of the evidence. Twenty-three statements on EUS-guided drainage of pancreatic cyst ablation were formulated. The statements addressed indications for the procedures, technical aspects, pre-procedure and post-procedure management, management of complications, and competency and training in the procedures. The current set of statements on EUS-guided pancreatic cyst ablation are the first to be published by any endoscopic society. Clinicians interested in developing the technique should reference these statements and future studies should address the key issues raised in the document.
最近，已发表了几份关于胰腺囊性肿瘤管理的指南，这些指南的建议各不相同，但内镜超声（EUS）引导下的胰腺囊肿消融术的作用尚未得到充分探讨。本文的目的是通过列出一系列临床问题并根据现有最佳科学证据提供答案，来探讨围绕EUS引导下胰腺囊肿消融术的相关问题。 EUS引导下胰腺囊肿消融术专家小组由亚洲EUS小组的成员和一个国际专家小组组成。创建了一系列临床问题，并将每个问题分配给一名成员以生成相应的陈述。然后在2016年10月至2017年10月期间的三次网络会议上对这些陈述进行了讨论。对陈述进行修改，直到达成共识。之后，将完整的陈述集发送给所有小组成员，对陈述的力度、陈述的分类和证据的分级进行投票。 制定了23条关于EUS引导下胰腺囊肿消融术引流的陈述。这些陈述涉及该手术的适应症、技术方面、术前和术后管理、并发症的处理以及该手术的能力和培训。 目前这套关于EUS引导下胰腺囊肿消融术的陈述是首个由任何内镜学会发表的。对开发该技术感兴趣的临床医生应参考这些陈述，未来的研究应解决本文中提出的关键问题。
