Wu Chien-Hui, Ho Te-Wei, Chen Ching-Hsuan, Chien Kuo-Liong, Tien Yu-Wen
Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine.
Institute of Epidemiology and Preventive Medicine, Department of Public Health, National Taiwan University.
Int J Surg. 2024 Dec 1;110(12):8224-8227. doi: 10.1097/JS9.0000000000002068.
Endoscopic ultrasound-guided aspiration or biopsy allows preoperative confirmation of malignancy but is not necessary for resectable pancreatic cancer. Preoperative biopsy may induce pancreatitis, making surgery difficult and complex. Therefore, the authors performed a retrospective study to evaluate the association between preoperative endoscopic ultrasound-guided biopsy and surgical outcomes in patients with resectable pancreatic head tumors.
A prospectively enrolled cohort from a single high-volume pancreatic center was analyzed. Between 2007 and 2019, a total of 518 patients with resectable pancreatic head tumors underwent pancreaticoduodenectomy. This analysis was performed to determine the association of preoperative endoscopic ultrasound-guided biopsy with operating time and major complications.
In 518 patients who received pancreaticoduodenectomy, 164 patients (31.6%) underwent preoperative endoscopic ultrasound-guided biopsy. Endoscopic ultrasound-guided biopsy increased surgical time (46.9 min, 95% CI: 25.1-68.8, P -value <0.05) without increasing complications (odds ratio: 0.53, 95% CI: 0.31-1.29, P -value=0.29).
Preoperative endoscopic ultrasound-guided biopsy for pancreatic head tumors may increase operative time but is not associated with an increased risk of mortality and complications.
内镜超声引导下穿刺抽吸或活检可实现术前恶性肿瘤的确诊,但对于可切除的胰腺癌并非必需。术前活检可能诱发胰腺炎,导致手术难度增加且过程复杂。因此,作者开展了一项回顾性研究,以评估术前内镜超声引导下活检与可切除胰头肿瘤患者手术结局之间的关联。
对来自一个高容量胰腺中心的前瞻性入组队列进行分析。2007年至2019年期间,共有518例可切除胰头肿瘤患者接受了胰十二指肠切除术。进行该分析以确定术前内镜超声引导下活检与手术时间及主要并发症之间的关联。
在接受胰十二指肠切除术的518例患者中,164例(31.6%)接受了术前内镜超声引导下活检。内镜超声引导下活检增加了手术时间(46.9分钟,95%置信区间:25.1 - 68.8,P值<0.05),但并未增加并发症(比值比:0.53,95%置信区间:0.31 - 1.29,P值 = 0.29)。
胰头肿瘤术前内镜超声引导下活检可能会增加手术时间,但与死亡率和并发症风险增加无关。