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.
Gut Liver. 2021 May 15;15(3):354-374. doi: 10.5009/gnl20302.
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 eight 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.
内镜超声(EUS)引导下胰腺实性肿瘤组织获取需要严格推荐其在临床实践中的正确应用,因为它具有技术难度和侵袭性。韩国胃肠内镜学会(KSGE)任命了一个工作组,为 EUS 引导下胰腺实性肿瘤组织获取制定临床实践指南。每个陈述的推荐强度和证据水平均根据 2014 年 Minds 临床实践指南制定手册进行分级。该委员会由 16 名超声内镜医师和指南制定方法专家组成的开发小组组成,制定了 12 项基于证据的建议,分为 8 个类别,旨在帮助医生就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 引导下的胰腺实性肿瘤采样,并就需要使用的情况、与最大限度提高诊断产量相关的技术问题(例如,针的类型、针的直径、足够的进针次数、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与学习相关的问题提出建议。本指南已经过外部专家的审查,并根据编写时可用的证据建议了最佳实践。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。它将根据技术和临床实践证据的进展和变化进行必要的修订。