PDF(Pubmed)
Abstract：
UNASSIGNED: Management of hepatic abscesses has traditionally been performed by image-guided percutaneous techniques. More recently, EUS drainage has been shown to be efficacious and safe. The aim of this study is to compare EUS-guided versus percutaneous catheter drainage (PCD) of hepatic abscesses.
UNASSIGNED: Patients who underwent EUS-guided drainage or PCD of hepatic abscesses from January 2018 through November 2021 from 4 international academic centers were included in a dedicated registry. Demographics, clinical data preprocedure and postprocedure, abscess characteristics, procedural data, adverse events, and postprocedure care were collected.
UNASSIGNED: Seventy-four patients were included (mean age, 63.9 years; 45% male): EUS-guided (n = 30), PCD (n = 44). Preprocedure Charlson Comorbidity Index scores were 4.3 for the EUS group and 4.3 for the PCD group. The median abscess size was 8.45 × 6 cm (length × width) in the EUS group versus 7.3 × 5.5 cm in the PCD group. All of the abscesses in the EUS group were left-sided, whereas the PCD group contained both left- and right-sided abscesses (29 and 15, respectively). Technical success was 100% in both groups. Ten-millimeter-diameter stents were used in most cases in the EUS group, and 10F catheters were used in the PCD group. The duration to resolution of symptoms from the initial procedure was 10.9 days less in the EUS group compared with the PCD group (P < 0.00001). Hospital length of stay was shorter in the EUS group by 5.2 days (P = 0.000126). The EUS group had significantly fewer number of repeat sessions: mean of 2 versus 7.7 (P < 0.00001) and trended toward fewer number of procedure-related readmissions: 10% versus 34%. The PCD group had a significantly higher number of adverse events (n = 27 [61%]) when compared with the EUS group (n = 5 [17%]; P = 0.0001).
UNASSIGNED: EUS-guided drainage is an efficacious and safe intervention for the management of hepatic abscesses. EUS-guided drainage allows for quicker resolution of symptoms, shorter length of hospital stay, fewer adverse events, and fewer procedural sessions needed when compared with the PCD technique. However, EUS-guided drainage may not be feasible in right-sided lesions.
UNASSIGNED: Patients who underwent EUS-guided drainage or PCD of hepatic abscesses from January 2018 through November 2021 from 4 international academic centers were included in a dedicated registry. Demographics, clinical data preprocedure and postprocedure, abscess characteristics, procedural data, adverse events, and postprocedure care were collected.
UNASSIGNED: Seventy-four patients were included (mean age, 63.9 years; 45% male): EUS-guided (n = 30), PCD (n = 44). Preprocedure Charlson Comorbidity Index scores were 4.3 for the EUS group and 4.3 for the PCD group. The median abscess size was 8.45 × 6 cm (length × width) in the EUS group versus 7.3 × 5.5 cm in the PCD group. All of the abscesses in the EUS group were left-sided, whereas the PCD group contained both left- and right-sided abscesses (29 and 15, respectively). Technical success was 100% in both groups. Ten-millimeter-diameter stents were used in most cases in the EUS group, and 10F catheters were used in the PCD group. The duration to resolution of symptoms from the initial procedure was 10.9 days less in the EUS group compared with the PCD group (P < 0.00001). Hospital length of stay was shorter in the EUS group by 5.2 days (P = 0.000126). The EUS group had significantly fewer number of repeat sessions: mean of 2 versus 7.7 (P < 0.00001) and trended toward fewer number of procedure-related readmissions: 10% versus 34%. The PCD group had a significantly higher number of adverse events (n = 27 [61%]) when compared with the EUS group (n = 5 [17%]; P = 0.0001).
UNASSIGNED: EUS-guided drainage is an efficacious and safe intervention for the management of hepatic abscesses. EUS-guided drainage allows for quicker resolution of symptoms, shorter length of hospital stay, fewer adverse events, and fewer procedural sessions needed when compared with the PCD technique. However, EUS-guided drainage may not be feasible in right-sided lesions.
摘要：
■肝脓肿的治疗传统上是通过图像引导的经皮技术进行的。最近,EUS排水已被证明是有效和安全的。这项研究的目的是比较肝脓肿的EUS引导和经皮导管引流（PCD）。
■从2018年1月至2021年11月从4个国际学术中心接受EUS引导下的肝脓肿引流或PCD的患者被纳入专门的注册表。人口统计,临床数据术前和术后，脓肿特点,程序数据,不良事件,并收集了术后护理。
■纳入74例患者(平均年龄，63.9岁；45%男性）：EUS指导（n=30），PCD(n=44)。EUS组和PCD组的术前Charlson合并症指数评分分别为4.3和4.3。EUS组脓肿大小中位数为8.45×6cm（长×宽），PCD组为7.3×5.5cm。EUS组的所有脓肿都是左侧的，而PCD组同时存在左侧和右侧脓肿(分别为29和15).两组的技术成功率均为100％。在EUS组中，大多数情况下使用10毫米直径的支架，PCD组使用10F导管。与PCD组相比，EUS组从初始程序到症状缓解的持续时间减少了10.9天（P<0.00001）。EUS组住院时间缩短5.2天(P=0.000126)。EUS组重复次数明显较少：平均2次与7.7次（P<0.00001），与手术相关的再入院次数较少：10％与34％。与EUS组（n=5[17%];P=0.0001）相比，PCD组的不良事件发生率明显更高（n=27[61%]）。
■EUS引导的引流是治疗肝脓肿的有效和安全的干预措施。EUS引导的引流可以更快地解决症状，住院时间缩短，减少不良事件，与PCD技术相比，所需的程序性会话更少。然而,EUS引导的引流在右侧病变中可能不可行。
■从2018年1月至2021年11月从4个国际学术中心接受EUS引导下的肝脓肿引流或PCD的患者被纳入专门的注册表。人口统计,临床数据术前和术后，脓肿特点,程序数据,不良事件,并收集了术后护理。
■纳入74例患者(平均年龄，63.9岁；45%男性）：EUS指导（n=30），PCD(n=44)。EUS组和PCD组的术前Charlson合并症指数评分分别为4.3和4.3。EUS组脓肿大小中位数为8.45×6cm（长×宽），PCD组为7.3×5.5cm。EUS组的所有脓肿都是左侧的，而PCD组同时存在左侧和右侧脓肿(分别为29和15).两组的技术成功率均为100％。在EUS组中，大多数情况下使用10毫米直径的支架，PCD组使用10F导管。与PCD组相比，EUS组从初始程序到症状缓解的持续时间减少了10.9天（P<0.00001）。EUS组住院时间缩短5.2天(P=0.000126)。EUS组重复次数明显较少：平均2次与7.7次（P<0.00001），与手术相关的再入院次数较少：10％与34％。与EUS组（n=5[17%];P=0.0001）相比，PCD组的不良事件发生率明显更高（n=27[61%]）。
■EUS引导的引流是治疗肝脓肿的有效和安全的干预措施。EUS引导的引流可以更快地解决症状，住院时间缩短，减少不良事件，与PCD技术相比，所需的程序性会话更少。然而,EUS引导的引流在右侧病变中可能不可行。
