Chung Moon Jae, Park Se Woo, Kim Seong-Hun, Cho Chang Min, Choi Jun-Ho, Choi Eun Kwang, Lee Tae Hoon, Cho Eunae, Lee Jun Kyu, Song Tae Jun, Lee Jae Min, Son Jun Hyuk, Park Jin Suk, Oh Chi Hyuk, Park Dong-Ah, Byeon Jeong-Sik, Lee Soo Teik, Kim Ho Gak, Chun Hoon Jai, Choi Ho Soon, Park Chan Guk, Cho Joo Young
Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Division of Gastroenterology, Department of Internal Medicine, Hallym University College of Medicine, Hwaseong, Korea.
Clin Endosc. 2021 Mar;54(2):161-181. doi: 10.5946/ce.2021.069. Epub 2021 Mar 24.
Endoscopic ultrasound (EUS)-guided tissue acquisition of pancreatic solid tumor requires a strict recommendation for its proper use in clinical practice because of its technical difficulty and invasiveness. The Korean Society of Gastrointestinal Endoscopy (KSGE) appointed a Task Force to draft clinical practice guidelines for EUS-guided tissue acquisition of pancreatic solid tumor. The strength of recommendation and the level of evidence for each statement were graded according to the Minds Handbook for Clinical Practice Guideline Development 2014. The committee, comprising a development panel of 16 endosonographers and an expert on guideline development methodology, developed 12 evidence-based recommendations in 8 categories intended to help physicians make evidence-based clinical judgments with regard to the diagnosis of pancreatic solid tumor. This clinical practice guideline discusses EUS-guided sampling in pancreatic solid tumor and makes recommendations on circumstances that warrant its use, technical issues related to maximizing the diagnostic yield (e.g., needle type, needle diameter, adequate number of needle passes, sample obtaining techniques, and methods of specimen processing), adverse events of EUS-guided tissue acquisition, and learning-related issues. This guideline was reviewed by external experts and suggests best practices recommended based on the evidence available at the time of preparation. This guideline may not be applicable for all clinical situations and should be interpreted in light of specific situations and the availability of resources. It will be revised as necessary to cover progress and changes in technology and evidence from clinical practice.
由于技术难度和侵入性,内镜超声(EUS)引导下胰腺实性肿瘤的组织获取在临床实践中的合理应用需要严格的推荐。韩国胃肠内镜学会(KSGE)任命了一个特别工作组来起草EUS引导下胰腺实性肿瘤组织获取的临床实践指南。根据《2014年临床实践指南制定的Minds手册》对每条陈述的推荐强度和证据水平进行分级。该委员会由16名内镜超声检查医师组成的制定小组和一名指南制定方法专家组成,制定了8类12条基于证据的推荐意见,旨在帮助医生对胰腺实性肿瘤的诊断做出基于证据的临床判断。本临床实践指南讨论了EUS引导下胰腺实性肿瘤的采样,并就其使用的情况、与最大化诊断率相关的技术问题(如针型、针直径、足够的穿刺次数、样本获取技术和标本处理方法)、EUS引导下组织获取的不良事件以及学习相关问题提出了建议。本指南经过外部专家审查,并根据编写时可用的证据提出了最佳实践建议。本指南可能不适用于所有临床情况,应根据具体情况和资源可用性进行解释。如有必要,将对其进行修订,以涵盖技术进展和临床实践证据的变化。