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经皮影像和内镜引导下胆道和胆囊疾病介入治疗的研究重点:来自介入放射学基金会多学科研究共识小组的会议记录。

Research Priorities in Percutaneous Image- and Endoscopy-Guided Interventions for Biliary and Gallbladder Diseases: Proceedings from the Society of Interventional Radiology Foundation Multidisciplinary Research Consensus Panel.

机构信息

Division of Vascular and Interventional Radiology, Northwestern University, Chicago, Illinois.

Division of Vascular and Interventional Radiology, University of Colorado, Aurora, Colorado.

出版信息

J Vasc Interv Radiol. 2022 Oct;33(10):1247-1257. doi: 10.1016/j.jvir.2022.06.025. Epub 2022 Jul 7.

Abstract

Recent technological advancements, including the introduction of disposable endoscopes, have enhanced the role of interventional radiology (IR) in the management of biliary and gallbladder diseases. There are unanswered questions in this growing field. The Society of Interventional Radiology Foundation convened a virtual research consensus panel consisting of a multidisciplinary group of experts to develop a prioritized research agenda regarding percutaneous image- and endoscopy-guided procedures for biliary and gallbladder diseases. The panelists discussed current data, opportunities for IR, and future efforts to maximize IR's ability and scope. A recurring theme throughout the discussions was to find ways to reduce the total duration of percutaneous drains and improve patients' quality of life. After the presentations and discussions, research priorities were ranked on the basis of their clinical relevance and impact. The research ideas ranked top 3 were as follows: (a) percutaneous multimodality management of benign anastomotic biliary strictures (laser vs endobiliary ablation vs cholangioplasty vs drain upsize protocol alone), (b) ablation of intraductal cholangiocarcinoma with and without stent placement, and (c) cholecystoscopy/choledochoscopy and lithotripsy in nonsurgical patients with calculous cholecystitis. Collaborative, retrospective, and prospective research studies are essential to answer these questions and improve the management protocols for patients with biliary and gallbladder diseases.

摘要

近期技术的进步,包括一次性内窥镜的引入,增强了介入放射学(IR)在胆道和胆囊疾病管理中的作用。在这个不断发展的领域中,仍存在一些悬而未决的问题。介入放射学基金会召集了一个由多学科专家组成的虚拟研究共识小组,制定了一个针对胆道和胆囊疾病的经皮影像和内镜引导下操作的优先研究议程。小组成员讨论了当前的数据、IR 的机会以及未来如何最大程度地提高 IR 的能力和范围。整个讨论过程中的一个反复出现的主题是找到减少经皮引流管总持续时间和提高患者生活质量的方法。在演示和讨论之后,根据临床相关性和影响对研究重点进行了排名。排名前三的研究思路如下:(a)良性吻合口胆管狭窄的经皮多模态管理(激光与内镜下消融与胆管成形术与引流管增大方案的比较),(b)有或无支架置入的胆管内癌的消融,以及(c)非手术患者的胆囊镜/胆管镜检查和碎石术治疗胆囊结石。协作、回顾性和前瞻性研究对于回答这些问题和改善胆道和胆囊疾病患者的管理方案至关重要。

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