韩国内镜超声引导下胰腺实体肿块组织取样的现行实践模式:一项全国性调查的结果。

Current Practice Patterns of Endoscopic Ultrasound-Guided Tissue Sampling for Pancreatic Solid Mass in Korea: Outcomes of a National Survey.

机构信息

Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.

Department of Internal Medicine, Wonkwang University College of Medicine, Iksan, Korea.

出版信息

Gut Liver. 2023 Mar 15;17(2):328-336. doi: 10.5009/gnl220131. Epub 2022 Sep 5.

Abstract

BACKGROUND/AIMS: Although endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) and fine needle biopsy (FNB) are widely used for tissue acquisition of pancreatic solid mass, the optimal strategy of this procedure has not been established yet. The aim of this nationwide study was to investigate the current practice patterns of EUS-FNA/FNB for pancreatic solid mass in Korea.

METHODS

The Policy-Quality Management of the Korean Pancreatobiliary Association (KPBA) developed a questionnaire containing 22 questions. An electronic survey consisting of the questionnaire was distributed by e-mail to members registered to the KPBA.

RESULTS

A total of 101 respondents completed the survey. Eighty respondents (79.2%) performed preoperative EUS-FNA/FNB for operable pancreatic solid mass. Acquire needles (60.4%) were used the most, followed by ProCore needles (47.5%). In terms of need size, most respondents (>80%) preferred 22-gauge needles regardless of the location of the mass. Negative suction with a 10-mL syringe (71.3%) as sampling technique was followed by stylet slow-pull (41.6%). More than three needle passes for EUS-FNA/FNB was performed by most respondents (>80%). The frequency of requiring repeated procedure was significantly higher in respondents with a low individual volume (<5 per month, p=0.001). Prophylactic antibiotics were routinely used in 39 respondents (38.6%); rapid on-site pathologic evaluation was used in 6.1%.

CONCLUSIONS

According to this survey, practices of EUS-FNA/FNB for pancreatic solid mass varied substantially, some of which differed considerably from the recommendations present in existing guidelines. These results suggest that the development of evidence-based quality guidelines fitting Korean clinical practice is needed to establish the optimal strategy for this procedure.

摘要

背景/目的:尽管内镜超声(EUS)引导下细针抽吸(FNA)和细针活检(FNB)广泛用于胰腺实性肿块的组织获取,但该操作的最佳策略尚未确定。本全国性研究旨在调查韩国 EUS-FNA/FNB 用于胰腺实性肿块的当前实践模式。

方法

韩国胆胰协会(KPBA)的政策-质量管理部门制定了一份包含 22 个问题的问卷。一份包含该问卷的电子调查通过电子邮件分发给向 KPBA 注册的成员。

结果

共有 101 名受访者完成了调查。80 名受访者(79.2%)对可切除的胰腺实性肿块进行了术前 EUS-FNA/FNB。使用最多的是获取针(60.4%),其次是 ProCore 针(47.5%)。就针的大小而言,大多数受访者(>80%)无论肿块位置如何,都更喜欢 22 号针。用 10mL 注射器进行负吸(71.3%)作为采样技术,其次是活检针缓慢拉拔(41.6%)。大多数受访者(>80%)进行了超过 3 次 EUS-FNA/FNB 针穿刺。对于个人量低的受访者(<5 例/月,p=0.001),需要重复操作的频率明显更高。39 名受访者(38.6%)常规使用预防性抗生素;6.1%的人使用快速现场病理评估。

结论

根据这项调查,EUS-FNA/FNB 用于胰腺实性肿块的实践差异很大,其中一些与现有指南中的建议有很大不同。这些结果表明,需要制定符合韩国临床实践的循证质量指南,以确定该操作的最佳策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dc6/10018297/6936a39475c5/gnl-17-2-328-f1.jpg

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