临床实践中的肝内科:EUS 引导下的门静脉压力测量与 EUS 引导下的肝活检以及门诊患者的静脉曲张筛查和治疗相结合

IF 4.4 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Sung Kim, Scot Lewey, Laura Meuller, Douglas G. Adler
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引用次数: 0

摘要

eus引导门静脉压力梯度(PPG)是一种新颖的技术,可以真实、直接地测量门静脉压力和肝静脉压力。本文详细介绍了我们在单个中心连续进行的20例门诊EUS-PPG手术的经验和教训,以及同时进行的eus引导下的肝活检、静脉曲张筛查和静脉曲张绑扎。回顾性分析了前20名在同一中心接受EUS-PPG治疗的患者的数据。评估各种肝脏疾病或其他患者相关因素对EUS-PPG测量以及eus引导肝活检(EUS-LB)的临床和技术成功的影响。在手术过程中,如果发现食管静脉曲张,则对其进行评估,如果认为有临床指征,则进行内镜下静脉曲张结扎。20例患者中男10例,女10例。所有手术在技术上都是成功的。所有患者门静脉和肝静脉均可轻易识别。在EUS-PPG测量过程中发生了出血的不良事件。所有20个eus - lb在技术上都是成功的,并产生了足够的组织学评估样本,每个样本平均有25个完整的门静脉束。在食管静脉曲张患者中,40%的患者接受了绑扎术。5例食管静脉曲张患者的平均EUS-PPG为11.6 mm Hg,而15例无食管静脉曲张患者的平均EUS-PPG为3.2 mm Hg。本研究证明EUS-PPG是一种新颖、安全、可重复、有效的技术。此外,EUS-PPG、EUS-LB、静脉曲张筛查和静脉曲张绑扎术可以在一个疗程内完成,并且可以在门诊基础上进行,这一事实说明了新生的内源性肝病学领域日益增长的相关性和影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Endohepatology in clinical practice: EUS-guided portal pressure measurement combined with EUS-guided liver biopsy and variceal screening and treatment in outpatients
EUS-guided portal pressure gradient (PPG) is a novel technique that permits a true, direct measure of portal vein pressure and hepatic vein pressure. This article details our experience and lessons learned from 20 consecutive outpatient EUS-PPG procedures performed at a single center, along with simultaneous EUS-guided liver biopsy, variceal screening, and variceal banding. Data on the first 20 patients who underwent EUS-PPG at a single center were retrospectively viewed and analyzed. The effects of various liver diseases or other patient-related factors on the clinical and technical success of EUS-PPG measurements, as well as EUS-guided liver biopsy (EUS-LB), were evaluated. During the procedure, if esophageal varices were encountered, they were assessed, and if felt to be clinically indicated, endoscopic variceal ligation was performed. The 20 patients included 10 male and 10 female patients. All procedures were technically successful. In all patients, the portal vein and hepatic veins could be easily identified. One adverse event of bleeding occurred during the EUS-PPG measuring procedure. All 20 EUS-LBs were technically successful and yielded adequate samples for histological evaluations, with an average of 25 complete portal tracts per sample. Among patients with esophageal varices, 40% of patients underwent banding. The mean EUS-PPG among 5 patients with esophageal varices was 11.6 mm Hg, compared with 3.2 mm Hg among 15 patients without esophageal varices. This study demonstrates that EUS-PPG is a novel, safe, reproducible, and effective technique. Also, the fact that EUS-PPG, EUS-LB, variceal screening, and variceal banding could be performed in 1 session and on an outpatient basis speaks to the growing relevance and impact of the nascent field of endohepatology.
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来源期刊
Endoscopic Ultrasound
Endoscopic Ultrasound GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
6.20
自引率
11.10%
发文量
144
期刊介绍: Endoscopic Ultrasound, a publication of Euro-EUS Scientific Committee, Asia-Pacific EUS Task Force and Latin American Chapter of EUS, is a peer-reviewed online journal with Quarterly print on demand compilation of issues published. The journal’s full text is available online at http://www.eusjournal.com. The journal allows free access (Open Access) to its contents and permits authors to self-archive final accepted version of the articles on any OAI-compliant institutional / subject-based repository. The journal does not charge for submission, processing or publication of manuscripts and even for color reproduction of photographs.
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