Same-day endoscopic retrograde cholangiopancreatography after transduodenal endoscopic ultrasoundguided needle aspiration: do we need to be cautious?

被引:21
作者
Di Matteo, F.
Shimpi, L.
Gabbrielli, A.
Martino, M.
Caricato, M.
Esposito, A.
De Cicco, M. L.
Coppola, R.
Costamagna, G.
机构
[1] Univ Campus Biomed, Dept Digest Dis, GI Endoscopy Unit, I-00155 Rome, Italy
[2] Univ Campus Biomed, Dept Digest Dis, Surg Unit, Rome, Italy
[3] Policlin Umberto 1, Radiol Unit DEA, Rome, Italy
[4] Univ Sacred Heart, Dept Surg Endoscopy, I-00168 Rome, Italy
关键词
D O I
10.1055/s-2006-944845
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Patients who are undergoing endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for suspected pancreatic tumors frequently undergo endoscopic retrograde cholangiopancreatography (ERCP) for palliation of their symptoms. Performing EUS-FNA and ERCP in tandem may be cost-effective and may reduce procedure time, but the potential risks associated with this approach have not been clearly defined in the literature. We report two patients who underwent same-day therapeutic ERCP after transduodenal EUS-FNA for pancreatic tumors. Endoscopic biliary manipulation during ERCP aggravated an in-advertent and subclinical needle puncture injury to the bile duct sustained during the preceding EUS-FNA. This resulted in leakage of bile into the retroperitoneal space, and both patients required laparotomy and surgical drainage. Additional clinical evidence is needed to clarify these issues and to determine whether it would be prudent to perform therapeutic ERCP prior to diagnostic transduodenal EUS-FNA when these two procedures are planned as sequential or same-day procedures. © Georg Thieme Verlag KG Stuttgart.
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页码:1149 / 1151
页数:3
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