Gastroenterology Unit, Department of Medical Sciences, University of Foggia, AOU Ospedali Riuniti, Viale Pinto 1, 71100 Foggia, Italy.
Gastroenterology Unit, Department of Medical Sciences, University of Foggia, AOU Ospedali Riuniti, Viale Pinto 1, 71100 Foggia, Italy.
Hepatobiliary Pancreat Dis Int. 2020 Feb;19(1):74-79. doi: 10.1016/j.hbpd.2019.10.001. Epub 2019 Oct 25.
Basic and clinical studies suggest that statins may prevent and even ameliorate acute pancreatitis. The present study was to evaluate whether statin decreases the risk of acute pancreatitis in patients undergoing endoscopic ultrasound-guided fine-needle aspiration of pancreatic cysts.
Out of 456 patients with pancreatic cysts referred to our center between 2006 and 2018, 365 were finally included in analyses: 86 were treated with statins and 279 were not at the time of endoscopic ultrasound fine-needle aspiration. We compared the acute pancreatitis incidence between the two groups, and we also compared other complications such as bleeding and infections.
Median age was 64 years [interquartile range (IQR) 62-69] and median cyst size was 24 mm (IQR, 21-29). The most frequent histology was intraductal papillary mucinous neoplasm (45.3% and 42.3% in the two groups, respectively; P = 0.98). All 13 patients experiencing post-endoscopic ultrasound acute pancreatitis were from the control group (4.7%), of which 3 were classified as severe pancreatitis. None of statin users developed post-procedural acute pancreatitis (odds ratio: 0.15; 95% confidence interval: 0.03-0.98; P = 0.03). No difference was registered with regard to severe pancreatitis and other complications.
Statins exert a beneficial role in preventing acute pancreatitis in patients with pancreatic cysts undergoing endoscopic ultrasound-guided fine-needle aspiration. If confirmed in prospective trials, our findings may pave the way to an extensive use of statins as prophylactic agents in pancreatic interventional endoscopy.
基础和临床研究表明，他汀类药物可能预防甚至改善急性胰腺炎。本研究旨在评估他汀类药物是否降低内镜超声引导下胰腺囊肿细针抽吸术患者发生急性胰腺炎的风险。
在 2006 年至 2018 年间，我们中心共对 456 例胰腺囊肿患者进行了内镜超声引导下细针抽吸术，其中 365 例最终纳入分析：86 例接受他汀类药物治疗，279 例在接受内镜超声引导下细针抽吸术时未接受他汀类药物治疗。我们比较了两组患者急性胰腺炎的发生率，并比较了其他并发症，如出血和感染。
中位年龄为 64 岁（四分位距 62-69 岁），中位囊肿大小为 24mm（四分位距 21-29mm）。最常见的组织学类型是导管内乳头状黏液性肿瘤（分别为 45.3%和 42.3%；P=0.98）。所有 13 例经内镜超声检查后发生急性胰腺炎的患者均来自对照组（4.7%），其中 3 例为重症胰腺炎。他汀类药物使用者无一例发生内镜超声检查后急性胰腺炎（优势比：0.15；95%置信区间：0.03-0.98；P=0.03）。两组重症胰腺炎和其他并发症的发生率无差异。
他汀类药物在预防内镜超声引导下胰腺囊肿细针抽吸术患者发生急性胰腺炎方面发挥了有益作用。如果在前瞻性试验中得到证实，我们的研究结果可能为在胰腺介入内镜中广泛使用他汀类药物作为预防性药物铺平道路。
