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非血管经皮腹部手术的医源性血管并发症。

Iatrogenic vascular complications of non-vascular percutaneous abdominal procedures.

机构信息

University of Arizona College of Medicine-Phoenix, 475 N 5th St, HSEB C523, Phoenix, AZ, 85004, USA.

出版信息

Abdom Radiol (NY). 2024 Nov;49(11):4074-4091. doi: 10.1007/s00261-024-04381-x. Epub 2024 Jun 7.

Abstract

PURPOSE

The purpose of this paper is to compile and present all of the reported vascular complications that resulted from common non-vascular abdominal procedures in the literature. Non-vascular procedures include, though are not limited to, percutaneous abscess/fluid collection drainage (PAD), percutaneous nephrostomy (PN), paracentesis, percutaneous transhepatic cholangiography (PTC)/percutaneous biliary drainage (PBD), percutaneous biliary stone removal, and percutaneous radiologic gastrostomy (PG)/percutaneous radiologic gastrojejunostomy (PG-J). By gathering this information, radiologists performing these procedures can be aware of the associated vascular injuries, as well as take steps to minimize risks.

METHODS

A literature review was conducted using the PubMed database to catalog relevant articles, published in the year 2000 onward, in which an iatrogenic vascular complication occurred from the following non-vascular abdominal procedures: PAD, PN, paracentesis, PTC/PBD, percutaneous biliary stone removal, and PG/PG-J. Biopsy and tumor ablation were deferred from this article.

RESULTS

214 studies met criteria for analysis. 28 patients died as a result of vascular complications from the analyzed non-vascular abdominal procedures. Vascular complications from paracentesis were responsible for 19 patient deaths, followed by four deaths from PTC/PBD, three from biliary stone removal, and two from PG.

CONCLUSION

Despite non-vascular percutaneous abdominal procedures being minimally invasive, vascular complications still can arise and be quite serious, even resulting in death. Through the presentation of vascular complications associated with these procedures, interventionalists can improve patient care by understanding the steps that can be taken to minimize these risks and to reduce complication rates.

摘要

目的

本文旨在汇编并呈现文献中所有与常见非血管腹部手术相关的血管并发症。非血管手术包括但不限于经皮脓肿/积液引流(PAD)、经皮肾造瘘术(PN)、经皮穿刺、经皮肝胆管造影术(PTC)/经皮胆道引流术(PBD)、经皮胆道取石术和经皮放射胃造口术(PG)/经皮放射胃空肠造口术(PG-J)。通过收集这些信息,执行这些手术的放射科医生可以了解相关的血管损伤,并采取措施降低风险。

方法

通过使用 PubMed 数据库进行文献回顾,对 2000 年以后发表的与以下非血管腹部手术相关的医源性血管并发症的相关文章进行分类:PAD、PN、经皮穿刺、PTC/PBD、经皮胆道取石术和 PG/PG-J。本文未涉及活检和肿瘤消融。

结果

214 项研究符合分析标准。28 例患者因非血管腹部手术的血管并发症而死亡。经皮穿刺引起的血管并发症导致 19 例患者死亡,其次是 PTC/PBD 引起的 4 例死亡、胆道取石引起的 3 例死亡和 PG 引起的 2 例死亡。

结论

尽管非血管经皮腹部手术为微创性,但仍可能发生血管并发症,且可能非常严重,甚至导致死亡。通过呈现与这些手术相关的血管并发症,介入医生可以通过了解可以采取哪些措施来降低这些风险并降低并发症发生率来改善患者的护理。

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