Gastrointestinal endoscopy · 2012
Initial experience with EUS-guided cholangiopancreatography for biliary and pancreatic duct drainage: a Spanish national survey.
Оценочное исследованиеСтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Vila Juan J, Pérez-Miranda Manuel, Vazquez-Sequeiros Enrique, Abadia Monder Abu-Suboh, Pérez-Millán Antonio, González-Huix Ferrán, Gornals Joan, Iglesias-Garcia Julio, De la Serna Carlos, Aparicio José R, Subtil José C, Alvarez Alberto, de la Morena Felipe, García-Cano Jesús, Casi María A, Lancho Angel, Barturen Angel, Rodríguez-Gómez Santiago J, Repiso Alejandro, Juzgado Diego, Igea Francisco, Fernandez-Urien Ignacio, González-Martin Juan A, Armengol-Miró José R
Аннотация
BACKGROUND: EUS-guided cholangiopancreatography (ESCP) allows transmural access to biliopancreatic ducts when ERCP fails. Data regarding technical details, safety, and outcomes of ESCP are still unknown.
OBJECTIVE: To evaluate outcomes of ESCP in community and referral centers at the initial development phase of this procedure, to identify the ESCP stages with higher risk of failure, and to evaluate the influence on outcomes of factors related to the endoscopist.
DESIGN: Multicenter retrospective study.
SETTING: Public health system hospitals with experience in ESCP in Spain.
PATIENTS: A total of 125 patients underwent ESCP in 19 hospitals, with an experience of <20 procedures.
INTERVENTION: ESCP.
MAIN OUTCOME MEASUREMENTS: Technical success and complication rates in the initial phase of implantation of ESCP are described. The influence of technical characteristics and endoscopist features on outcomes was analyzed.
RESULTS: A total of 125 patients from 19 hospitals were included. Biliary ESCP was performed in 106 patients and pancreatic ESCP was performed in 19. Technical success was achieved in 84 patients (67.2%) followed by clinical success in 79 (63.2%). Complications occurred in 29 patients (23.2%). Unsuccessful manipulation of the guidewire was responsible for 68.2% of technical failures, and 58.6% of complications were related to problems with the transmural fistula.
LIMITATIONS: Retrospective study.
CONCLUSION: Outcomes of ESCP during its implantation stage reached a technical success rate of 67.2%, with a complication rate of 23.2%. Intraductal manipulation of the guidewire seems to be the most difficult stage of the procedure.
OBJECTIVE: To evaluate outcomes of ESCP in community and referral centers at the initial development phase of this procedure, to identify the ESCP stages with higher risk of failure, and to evaluate the influence on outcomes of factors related to the endoscopist.
DESIGN: Multicenter retrospective study.
SETTING: Public health system hospitals with experience in ESCP in Spain.
PATIENTS: A total of 125 patients underwent ESCP in 19 hospitals, with an experience of <20 procedures.
INTERVENTION: ESCP.
MAIN OUTCOME MEASUREMENTS: Technical success and complication rates in the initial phase of implantation of ESCP are described. The influence of technical characteristics and endoscopist features on outcomes was analyzed.
RESULTS: A total of 125 patients from 19 hospitals were included. Biliary ESCP was performed in 106 patients and pancreatic ESCP was performed in 19. Technical success was achieved in 84 patients (67.2%) followed by clinical success in 79 (63.2%). Complications occurred in 29 patients (23.2%). Unsuccessful manipulation of the guidewire was responsible for 68.2% of technical failures, and 58.6% of complications were related to problems with the transmural fistula.
LIMITATIONS: Retrospective study.
CONCLUSION: Outcomes of ESCP during its implantation stage reached a technical success rate of 67.2%, with a complication rate of 23.2%. Intraductal manipulation of the guidewire seems to be the most difficult stage of the procedure.
Предметные рубрики MeSH
AgedAged, 80 and overBiliary Tract DiseasesCholangiographyDrainageEndoscopy, Digestive SystemEndosonographyFemaleHealth Care SurveysHumansLogistic ModelsMaleMiddle AgedMultivariate AnalysisPancreatic DiseasesPancreatic DuctsRetrospective StudiesSpainStentsTreatment OutcomeUltrasonography, Interventional