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首页> 外文期刊>Endoscopy International Open >EUS-guided fiducial placement for pancreatobiliary malignancies: safety, infection risk, and use of peri-procedural antibiotics
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EUS-guided fiducial placement for pancreatobiliary malignancies: safety, infection risk, and use of peri-procedural antibiotics

机译：胰岛胰腺炎恶性肿瘤的指导基准安置：安全性，感染风险和Peri-properation抗生素的使用

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Background and study aims?Chemoradiation with stereotactic body radiation therapy (SBRT) is increasingly being used for optimal treatment of locally advanced pancreatobiliary cancers. Fiducial markers are used to track these tumors during SBRT. Endoscopic ultrasound (EUS) is the preferred route for fiducial marker placement for ease of access to pancreatobiliary structures and accurate placement. Here we evaluate the safety and infection risk associated with EUS-guided fiducial placement for pancreatobiliary malignancies and use of peri-procedural prophylactic antibiotics. Patients and methods?This was a retrospective, single-center study including consecutive patients presenting for EUS-guided fiducial placement in pancreatobiliary region by three expert interventional endoscopists for SBRT from July 2010 to February 2018 at a tertiary care center. Patient demographics, tumor characteristics, EUS technique, fiducials, use of prophylactic antibiotics, adverse events (AEs) and SBRT/Cyberknife administration were reported. Results?A total of 355 patients with pancreatobiliary malignancy underwent EUS-guided fiducial placement, of whom 308 patients (86.76?%) successfully underwent SBRT. Of the patients, 304 (85.63?%) received peri-procedural prophylactic antibiotic. Of 355 total patients, 5.9?% (n?=?21) were noted to develop AEs (mild to severe) with no significant difference in incidence of infection with or without use of peri-procedural prophylactic antibiotic. Only three patients developed infectious AEs, none of which were definitively related to fiducial placement. Conclusion?EUS-guided fiducial placement for pancreatobiliary malignancy is safe and efficacious, and risk of infection is rare, regardless of whether or not peri-procedural antibiotics are used. We favor limiting routine use of peri-procedural antibiotics for patients undergoing EUS-guided fiducial placement in pancreaticobiliary malignancy.
机译：背景和研究旨在介绍型静态体辐射治疗（SBRT）的趋化越来越多地用于局部晚期胰腺癌的最佳处理。基准标记用于在SBRT期间跟踪这些肿瘤。内窥镜超声（EUS）是基准标记放置的优选路线，以便于进入胰腺结构和精确放置。在这里，我们评估与胰岛素恶性肿瘤的无尽基准安置的安全性和感染风险，以及使用Peri-properational预防性抗生素的使用。患者和方法？这是一项回顾性的单中心研究，包括在2010年7月至2018年2月至2018年2月在第三级护理中心的三个专家介入内窥镜专家的三位专家介入内窥镜手中出现了连续患者。报道了患者人口统计学，肿瘤特征，eus技术，基准，预防性抗生素，不良事件（AES）和SBRT / Cyber​​ Knife施用的使用。结果？共有355例胰腺炎恶性肿瘤患者接受了令人反感的基准放置，其中308名患者（86.76？％）成功完成了SBRT。患者，304（85.63倍）接受Peri-proplyural预防性抗生素。总患者355例，5.9？％（n？=β21），以开发AES（轻度至严重），没有任何癌症预防抗生素的感染发生率没有显着差异。只有三名患者发育传染性AES，其中一定是无疑与基准安置有关。结论是恐慌性恶性肿瘤的EUS引导的基准安置是安全和有效的，无论是否使用静脉治疗抗生素，感染风险都是罕见的。有利于限制常规使用Peri-properational抗生素对胰岛素胆结性恶性肿瘤的肠道指导放置的患者。

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