Talreja Jayant P, Shami Vanessa M, Ku Jennifer, Morris Tanya D, Ellen Kristi, Kahaleh Michel
Digestive Health Center of Excellence, University of Virginia Health System, Charlottesville, Virginia 22908-0708, USA.
Gastrointest Endosc. 2008 Dec;68(6):1199-203. doi: 10.1016/j.gie.2008.06.015.
Drainage of pancreatic-fluid collections (PFCs) by using fully covered self-expanding metallic stents (CSEMSs) offers the option of providing a larger-diameter access fistula for drainage when compared with plastic stents.
To evaluate the efficacy and safety of transenteric drainage of PFCs by using CSEMSs.
A prospective case series.
A tertiary-referral center.
Between January 2007 and September 2007, 18 patients underwent drainage of PFCs by using CSEMSs. Follow-up and final results were prospectively recorded until May 2008.
Placement of CSEMSs with a double-pigtail stent placed alongside (4 cases) or into the CSEMS (14 cases) to prevent migration.
The number of sessions and time to resolution of the PFCs.
A median of 1 session was required to achieve drainage (range 1-4) when using CSEMSs. Complications included superinfection (5), bleeding (2), and inner migration (1). A total of 17 of 18 patients (95%) responded successfully, with 14 patients (78%) achieving complete resolution of their PFC. The mean (+/- SD) time of follow-up until final resolution was 77 +/- 80 days (range 15-310 days).
Placement of CSEMSs seems to offer an effective and safe alternative for the drainage of PFCs. A randomized controlled trial should be performed to compare this technique with plastic-stent drainage.
与塑料支架相比，使用全覆膜自膨式金属支架（CSEMSs）引流胰液性积液（PFCs）可提供更大直径的引流通道。
评估使用CSEMSs经肠道引流PFCs的有效性和安全性。
前瞻性病例系列研究。
三级转诊中心。
2007年1月至2007年9月，18例患者使用CSEMSs进行PFCs引流。前瞻性记录随访情况及最终结果直至2008年5月。
放置CSEMSs，同时放置双猪尾支架（4例）或放入CSEMSs内（14例）以防止移位。
PFCs引流所需的次数及积液消退时间。
使用CSEMSs引流时，达到引流的中位数为1次（范围1 - 4次）。并发症包括严重感染（5例）、出血（2例）和向内移位（1例）。18例患者中有17例（95%）成功，14例（78%）患者的PFC完全消退。直至最终消退的平均（±标准差）随访时间为77 ± 80天（范围15 - 310天）。
放置CSEMSs似乎为PFCs引流提供了一种有效且安全的替代方法。应进行随机对照试验以将该技术与塑料支架引流进行比较。
