Ferlitsch A, Oesterreicher C, Dumonceau J M, Deviere J, Leban T, Born P, Rösch T, Suter W, Binek J, Meyenberger C, Müllner M, Schneider B, Schöfl R
Dept. of Internal Medicine IV, Division of Gastroenterology and Hepatology, University of Vienna, Waeringer Guertel 18-20, 1090 Vienna, Austria.
Endoscopy. 2001 Aug;33(8):645-50. doi: 10.1055/s-2001-16214.
Various types of self-expandable metal stents have been introduced for biliary drainage in patients with malignant jaundice, showing prolonged patency compared with plastic endoprostheses. However, there has only been prolonged experience with a meaningful number of patients using the Wallstent. We evaluated the Diamond stent, a self-expanding uncoated biliary metal stent, in a prospective uncontrolled multicenter setting.
The eligibility criterion was obstructive jaundice due to inoperable malignant disease. Between August 1995 and January 2000, 126 patients, who received a total of 134 Diamond stents in four European centers, were followed prospectively.
Technical and clinical success rates were 96 % and 98 %, respectively. No major procedure-related complications occurred. The 30-day mortality rate was 13 %. Stent occlusion occurred in 28 patients (22 %). Overall median stent patency was 477 days; overall median survival was 173 days. Stent occlusion, confirmed by endoscopic retrograde cholangiopancreatography, was successfully treated with plastic stents in all patients. Cost analysis revealed estimated costs of 3440 euros per patient for palliative treatment with the Diamond stent.
The Diamond stent compares favorably with other biliary metal stents for patients requiring biliary drainage of malignant jaundice.
已引入多种类型的自膨式金属支架用于恶性黄疸患者的胆道引流，与塑料内支架相比，其通畅时间延长。然而，仅有大量患者长期使用Wallstent支架的经验。我们在一项前瞻性非对照多中心研究中对Diamond支架（一种未涂层的自膨式胆道金属支架）进行了评估。
入选标准为因无法手术的恶性疾病导致的梗阻性黄疸。1995年8月至2000年1月期间，欧洲四个中心的126例患者共接受了134枚Diamond支架，并进行了前瞻性随访。
技术成功率和临床成功率分别为96%和98%。未发生与手术相关的严重并发症。30天死亡率为13%。28例患者（22%）出现支架闭塞。支架总体中位通畅时间为477天；总体中位生存期为173天。经内镜逆行胰胆管造影证实的支架闭塞在所有患者中均成功采用塑料支架治疗。成本分析显示，使用Diamond支架进行姑息治疗的每位患者估计成本为3440欧元。
对于需要进行恶性黄疸胆道引流的患者，Diamond支架与其他胆道金属支架相比具有优势。
