PDF(Pubmed)
Abstract：
Endoscopic ultrasound (EUS) with fine needle aspiration or fine needle biopsy is the gold standard for sampling tissue to diagnose pancreatic cancer and autoimmune pancreatitis or to analyze cyst fluid. The most common reported adverse event of fine needle aspiration and/or fine needle biopsy is acute pancreatitis, which is likely induced by the same pathophysiological mechanisms as after endoscopic retrograde cholangiopancreatography (ERCP). According to the current European Society of Gastrointestinal Endoscopy guideline, nonsteroidal anti-inflammatory drugs are administered prior to ERCP as a scientifically proven treatment to reduce post-ERCP pancreatitis incidence rate. A single suppository of diclofenac or indomethacin prior to EUS guided tissue acquisition (TA) is harmless in healthy adults. Since it is associated with low costs and, most important, may prevent a dreadsome complication, we strongly recommend the administration of 100 mg diclofenac rectally prior to EUS-TA. We will explain this recommendation in more detail in this review as well as the risk and pathophysiology of post-EUS TA pancreatitis.
摘要：
采用细针穿刺或细针活检的内镜超声（EUS）是组织采样以诊断胰腺癌和自身免疫性胰腺炎或分析囊肿液的金标准。细针抽吸和/或细针活检最常见的不良事件是急性胰腺炎。这可能是由与内镜逆行胰胆管造影术（ERCP）后相同的病理生理机制引起的。根据目前的欧洲胃肠内镜学会指南，非甾体类抗炎药在ERCP之前给药,作为一种科学证明的治疗方法,可降低ERCP后胰腺炎的发生率.在EUS引导的组织采集（TA）之前，双氯芬酸或吲哚美辛的单一栓剂对健康成年人无害。由于它与低成本相关，最重要的,可以防止可怕的并发症，我们强烈建议在EUS-TA之前直肠给药100mg双氯芬酸.我们将在这篇综述中更详细地解释这一建议，以及EUSTA后胰腺炎的风险和病理生理学。
