Interventional endoscopic ultrasonography: an overview of safety and complications
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- 作者：María Victoria Alvarez-Sánchez (1)
Christian Jenssen (2)
Siegbert Faiss (3)
Bertrand Napoléon (1) - 关键词：Endoscopic ultrasound ; Celiac plexus ; Pancreatic collections ; Pelvic collections ; Biliary drainage ; Pancreatic drainage
- 刊名：Surgical Endoscopy
- 出版年：2014
- 出版时间：March 2014
- 年：2014
- 卷：28
- 期：3
- 页码：712-734
- 全文大小：378 KB
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120. Dietrich CF, Hocke M, Jenssen C (2011) Interventional endosonography. Ultraschall Med 32:8-2 quiz 23-5 - 作者单位：María Victoria Alvarez-Sánchez (1)
Christian Jenssen (2)
Siegbert Faiss (3)
Bertrand Napoléon (1)
1. Department of Gastroenterology and Hepatology, H?pital Privé Jean Mermoz, 55 Avenue Jean Mermoz, 69008, Lyon, France
2. Department of Internal Medicine, Krankenhaus M?rkisch-Oderland, Wriezen, Strausberg, Germany
3. Department of Gastroenterology and Hepatology, Asklepios Klinik Barmbek, Hamburg, Germany - ISSN：1432-2218
文摘
Background In recent years, endoscopic ultrasonography (EUS)-guided techniques have been developed as alternatives to surgical, radiologic, or conventional endoscopic approaches for the treatment or palliation of several digestive diseases. The use of EUS guidance allows the therapeutic area to be targeting more precisely, with a possible clinical benefit and less morbidity. Nevertheless, the risks persist and must be taken into consideration. This review gives an overview of the complications observed?with the most established procedures of therapeutic EUS. Methods The PubMed and Embase databases were used to search English language articles on interventional EUS. The studies considered for inclusion were those reporting on complications of EUS-guided celiac plexus block (EUS-CPB), EUS-guided celiac plexus neurolysis (EUS-CPN), drainage of fluid pancreatic and pelvic collections, and EUS-guided biliary and pancreatic drainage (EUS-BD and EUS-PD). Variations in methodology and design in most studies made a thorough statistical analysis difficult. Instead, a frequency analysis of complications and a critical discussion were performed. Results Although EUS-guided celiac plexus injection causes mainly mild and transient complications, growing experience shows that EUS-CPN is not as benign a procedure as previously thought. Most of the major complications have been observed in patients with chronic pancreatitis. The findings show that EUS-guided drainage of fluid collections is a safe procedure. Complications occur more often after the drainage of pancreatic abscesses and necrosis. Although the heterogeneity of studies dealing with pancreatobiliary drainage makes the evaluation of risks after these procedures difficult, complications after EUS-BD and EUS-PD are relatively frequent and can be severe. The technical complexity and the lack of specifically designed devices may account for their complication rates. Conclusions Clinicians can consider EUS-guided celiac injection and EUS-guided drainage of fluid collections to be safe alternatives to surgical and radiologic interventions. Well-designed prospective trials are needed to assess the risks of EUS-BD and EUS-PD accurately before they are broadly advocated after a failed endoscopic retrograde cholangiopancreatography (ERCP).