ERCP与EUS-FNA融合技术对胰腺癌合并梗阻性黄疸的诊治效能

赵亦周; 李佳宁; 王强; 伍东升; 张晟瑜; 吴晰; 郭涛; 蒋青伟; 杨莹韵; 施文; 冯云路; 杨爱明

doi:10.12290/xhyxzz.2024-0207

ERCP与EUS-FNA融合技术对胰腺癌合并梗阻性黄疸的诊治效能

The Efficacy of Combined Endoscopic Ultrasound Fine-needle Aspiration and Endoscopic Retrograde Cholangiopancreatography in Same Session for the Diagnosis and Management of Pancreatic Carcinoma with Obstructive Jaundice

摘要

摘要:
目的探讨超声内镜引导下细针穿刺术(endoscopic ultrasound fine-needle aspiration, EUS-FNA)和内镜下逆行胰胆管造影术(endoscopic retrograde cholangiopancreatography, ERCP)融合技术在胰腺癌合并梗阻性黄疸患者诊疗中的应用价值。
方法回顾性收集2023年1月1日—2024年2月26日北京协和医院消化内科住院接受ERCP胆管支架引流胰腺癌合并梗阻性黄疸患者的临床资料。根据是否在同一内镜单元进行EUS-FNA, 将其分为融合技术组和单纯ERCP组。比较两组病理诊断率、ERCP引流成功率、术后并发症发生率及患者单次住院时间差异。
结果共入选符合纳入与排除标准的接受ERCP胆管支架引流的胰腺癌合并梗阻性黄疸患者161例, 其中融合技术组80例, 单纯ERCP组81例。融合技术组病理诊断率高于单纯ERCP组92.50%(74/80)比46.15%(12/26), P＜0.001, ERCP引流成功率82.50%(66/80)比86.42%(70/81), P=0.360、术后总并发症发生率5.00%(4/80)比2.47%(2/81), P=0.443、单次住院时间4(4, 7)d比5(3, 9)d, P=0.397与单纯ERCP组均无统计学差异。
结论 EUS-FNA与ERCP融合技术可显著提升胰腺癌合并梗阻性黄疸病理诊断率, 且不影响ERCP引流效果, 不增加术后并发症率发生率, 有助于提高临床诊疗效率。

Abstract:
Objective To explore the application value of endoscopic ultrasound fine-needle aspiration (EUS-FNA) and endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis and treatment ofpatients with pancreatic cancer combined with obstructive jaundice.
Methods Clinical data of patients hospitalized in the Department of Gastroenterology of Peking Union Medical College Hospital who underwent ERCP biliary stent drainage for pancreatic cancer combined with obstructive jaundice from January 1, 2023 to February 26, 2024 were retrospectively collected. They were categorized into the fusion technology group and the simple ERCP group according to whether EUS-FNA was performed in the same endoscopic unit. The differences in pathologic diagnosis rate, ERCP drainage success rate, postoperative complication rate and patients' single hospitalization time were compared between the two groups.
Results A total of 161 patients with pancreatic cancer combined with obstructive jaundice who underwent ERCP biliary stent drainage meeting the inclusion and exclusion criteria were enrolled, of which 80 were in the fusion technique group and 81 were in the simple ERCP group. The pathological diagnosis rate in the fusion technique group was higher than that in the simple ERCP group92.50%(74/80) vs. 46.15%(12/26), P < 0.001, and the ERCP drainage success rate82.50%(66/80) vs. 86.42%(70/81), P=0.360, the overall postoperative complication rate5.00%(4/80) vs. 2.47%(2/81), P=0.443, and single hospitalization time4 (4, 7)d vs. 5 (3, 9)d, P=0.397 were not statistically different from simple ERCP groups.
Conclusion The fusion of EUS-FNA and ERCP enhances the efficiency of diagnosis and treatment for pancreatic carcinoma, warranting widespread adoption and further research.

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