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Endoscopic Ultrasound-Guided Drainage without Fluoroscopic Guidance for Extraluminal Complicated Cysts

机译:内镜超声引导下引流管腔内复杂性囊肿无荧光检查指导

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摘要

Background. Endoscopic ultrasound- (EUS-) guided drainage is generally performed under fluoroscopic guidance. However, improvements in endoscopic and EUS techniques and experience have led to questions regarding the usefulness of fluoroscopy. This study aimed to retrospectively evaluate the safety and efficacy of EUS-guided drainage of extraluminal complicated cysts without fluoroscopic guidance. Methods. Patients who had undergone nonfluoroscopic EUS-guided drainage of extraluminal complicated cysts were enrolled. Drainage was performed via a transgastric, transduodenal, or transrectal approach. Single or double 7 Fr double pigtail stents were inserted. Results. Seventeen procedures were performed in 15 patients in peripancreatic fluid collections (n = 13) and pelvic abscesses (n = 4). The median lesion size was 7.1 cm (range: 2.8–13.0 cm), and the mean time spent per procedure was 26.2 ± 9.8 minutes (range: 16–50 minutes). Endoscopic drainage was successful in 16 of 17 (94.1%) procedures. There were no complications. All patients experienced symptomatic improvement and revealed partial to complete resolution according to follow-up computed tomography findings. Two patients developed recurrent cysts that were drained during repeat procedures, with eventual complete resolution. Conclusion. EUS-guided drainage without fluoroscopic guidance is a technically feasible, safe, and effective procedure for the treatment of extraluminal complicated cysts.
机译:背景。内镜超声引导下引流通常在荧光镜引导下进行。然而,内窥镜检查和EUS技术和经验的改进导致了有关荧光检查的实用性的疑问。这项研究旨在回顾性评估EUS引导下无荧光检查指导的腔内复杂囊肿引流的安全性和有效性。方法。接受非荧光镜下超声内镜引导下腔外复杂性囊肿引流的患者。通过经胃,经十二指肠或经直肠的方法进行引流。插入一个或两个7 Fr双尾纤支架。结果。对15例胰周液收集(n = 13)和盆腔脓肿(n = 4)的患者进行了17次手术。中位病变大小为7.1厘米(范围:2.8-13.0厘米),平均每次手术时间为26.2±9.8分钟(范围:16-50分钟)。内窥镜引流术在17例中有16例成功(94.1%)。没有并发症。根据随访的计算机体层摄影检查结果,所有患者均出现症状改善,并显示部分或完全缓解。两名患者发展为复发性囊肿,在重复手术期间引流,最终完全消退。结论。 EUS引导下无需透视检查的引流术是治疗腔外复杂性囊肿的技术上可行,安全且有效的方法。

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