美国胃肠内窥镜协会 (ASGE) 的这份临床实践指南为内窥镜在胰腺肿块的诊断和治疗中的作用提供了循证方法。本文件是使用建议评估、制定和评估分级框架制定的，涉及针头选择（细针活检 [FNB] 针与 FNA 针）、针口径（22 号针与 25 号针）、FNB 针类型（新颖或现代的[叉尖和 Franseen] 与替代的 FNB 针设计），以及样品处理（快速现场评估 [ROSE] 与无 ROSE）。此外，本指南还讨论了支架选择（自膨胀金属支架 [SEMS] 与塑料支架）、SEMS 类型（覆盖式 [cSEMS] 与非覆盖式 [uSEMS]）以及疼痛管理（腹腔神经丛神经松解术 [CPN] 与药物镇痛治疗） ）。对于接受 EUS 引导组织采集 (EUS-TA) 的胰腺实性肿块患者，ASGE 建议使用 FNB 针而不是 FNA 针。关于针口径，ASGE 建议使用 22 号针而不是 25 号针。当使用 FNB 针时，ASGE 建议使用叉尖或 Franseen 针，而不是其他 FNB 针设计。获得样本后，ASGE 建议不要在对实性胰腺肿块进行初始 EUS-TA 治疗的患者中常规使用 ROSE。对于接受 ERCP 引流的远端恶性胆道梗阻患者，ASGE 建议使用 SEMS 而非塑料支架。对于接受 SEMS 放置的已证实患有恶性肿瘤的患者，ASGE 建议使用 cSEMS 而不是 uSEMS。如果恶性肿瘤尚未得到组织病理学证实，ASGE 建议不要使用 uSEMS。最后，对于患有不可切除的胰腺癌和腹痛的患者，ASGE 建议使用 CPN 作为治疗腹痛的辅助手段。本文件概述了用于达成最终建议的过程、分析和决策方法，并代表了 ASGE 关于上述主题的官方建议。版权所有 © 2024 美国胃肠内窥镜学会。由爱思唯尔公司出版。保留所有权利。

This clinical practice guideline from the American Society for Gastrointestinal Endoscopy (ASGE) provides an evidence-based approach for the role of endoscopy in the diagnosis and management of pancreatic masses. This document was developed using the Grading of Recommendations Assessment, Development and Evaluation framework and addresses needle selection (fine-needle biopsy [FNB] needle vs FNA needle), needle caliber (22-gauge vs 25-gauge needles), FNB needle type (novel or contemporary [fork-tip and Franseen] vs alternative FNB needle designs), and sample processing (rapid on-site evaluation [ROSE] vs no ROSE). In addition, this guideline addresses stent selection (self-expandable metal stent [SEMS] vs plastic stent), SEMS type (covered [cSEMS] vs uncovered [uSEMS]), and pain management (celiac plexus neurolysis [CPN] vs medical analgesic therapy). In patients with solid pancreatic masses undergoing EUS-guided tissue acquisition (EUS-TA), the ASGE recommends FNB needles over FNA needles. With regard to needle caliber, the ASGE suggests 22-gauge over 25-gauge needles. When an FNB needle is used, the ASGE recommends using either a fork-tip or a Franseen needle over alternative FNB needle designs. After a sample has been obtained, the ASGE suggests against the routine use of ROSE in patients undergoing an initial EUS-TA of a solid pancreatic mass. In patients with distal malignant biliary obstruction undergoing drainage with ERCP, the ASGE suggests using SEMSs over plastic stents. In patients with proven malignancy undergoing SEMS placement, the ASGE suggests using cSEMSs over uSEMSs. If malignancy has not been histopathologically confirmed, the ASGE recommends against the use of uSEMSs. Finally, in patients with unresectable pancreatic cancer and abdominal pain, the ASGE suggests the use of CPN as an adjunct for the treatment of abdominal pain. This document outlines the process, analyses, and decision approaches used to reach the final recommendations and represents the official ASGE recommendations on the above topics.Copyright © 2024 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.