Same versus separate sessions of endoscopic ultrasound-guided fine-needle biopsy and endoscopic retrograde cholangiopancreatography for distal malignant biliary obstruction: a propensity score-matched study.

IF 3.8 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-09-01 Epub Date: 2024-09-02 DOI:10.1080/17474124.2024.2399176

Stefano Francesco Crinò, Alberto Zorzi, Piero Tavian, Nicolò De Pretis, Antonio Facciorusso, Jahnvi Dhar, Jayanta Samanta, Sokol Sina, Erminia Manfrin, Luca Frulloni, Maria Cristina Conti Bellocchi

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引用次数: 0

Abstract

Background: Same-session endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) is an attractive policy for patients with distal malignant biliary obstruction (DMBO) requiring fine-needle biopsy (FNB) and biliary drainage. However, scanty and conflicting data exists regarding safety and efficacy when comparing these two procedures performed in same versus separate sessions.

Methods: Single-center, retrospective, propensity score-matched study including patients with DMBO who underwent EUS-FNB followed by ERCP during the same or separate sessions. The primary outcome was the safety of the procedure [number of patients experiencing adverse events (AEs), overall AEs, its severity, post-ERCP pancreatitis (PEP)]. Secondary outcomes were successful ERCP, use of advanced cannulation techniques, EUS-FNB adequacy, length of hospital stay, overall procedure time, and time to recurrent biliary obstruction.

Results: After propensity matching, 87 patients were allocated to each group. AEs developed in 23 (26.4%) vs. 17 (19.5%) patients in the same and separate sessions group, respectively (p = 0.280). The overall number, the severity of AEs, and the rate of PEP were similar in the two groups. Secondary outcome parameters were also comparable in the 2 groups.

Conclusions: Same-session EUS-FNB followed by ERCP with biliary drainage is safe and does not impair technical outcomes of tissue adequacy and biliary cannulation.

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内镜超声引导下细针活检和内镜逆行胰胆管造影治疗远端恶性胆道梗阻的相同疗程与不同疗程：倾向评分匹配研究。

背景：对于需要进行细针穿刺活检（FNB）和胆道引流的远端恶性胆道梗阻（DMBO）患者来说，同一次内镜超声（EUS）和内镜逆行胰胆管造影（ERCP）是一项极具吸引力的治疗方案。然而，关于这两种手术的安全性和疗效，在同一疗程和不同疗程中进行比较的数据很少，而且相互矛盾：方法：单中心、回顾性、倾向评分匹配研究，包括接受 EUS-FNB 和 ERCP 的 DMBO 患者。主要结果是手术的安全性[发生不良事件（AEs）的患者人数、总体AEs、其严重程度、ERCP术后胰腺炎（PEP）]。次要结果是ERCP的成功率、先进插管技术的使用、EUS-FNB的充分性、住院时间、总手术时间和复发胆道梗阻的时间：经过倾向匹配后，87名患者被分配到每组。同一疗程组和单独疗程组分别有 23 例（26.4%）和 17 例（19.5%）患者发生 AE（P = 0.280）。两组患者的AEs总数、严重程度和PEP率相似。两组的次要结果参数也相当：结论：同一次 EUS-FNB 后进行 ERCP 胆道引流是安全的，不会影响组织充分性和胆道插管的技术结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Gastroenterology & Hepatology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

6.80

自引率

2.60%

发文量

审稿时长

6-12 weeks

期刊介绍： The enormous health and economic burden of gastrointestinal disease worldwide warrants a sharp focus on the etiology, epidemiology, prevention, diagnosis, treatment and development of new therapies. By the end of the last century we had seen enormous advances, both in technologies to visualize disease and in curative therapies in areas such as gastric ulcer, with the advent first of the H2-antagonists and then the proton pump inhibitors - clear examples of how advances in medicine can massively benefit the patient. Nevertheless, specialists face ongoing challenges from a wide array of diseases of diverse etiology.