Weickert U, Zimmerling S, Eickhoff A, Riemann J F, Reiss G
Department of Medicine II, SLK-Kliniken Heilbronn, Am Gesundbrunnen 20 - 26, 74078 Heilbronn.
Z Gastroenterol. 2009 Apr;47(4):347-50. doi: 10.1055/s-2008-1027926. Epub 2009 Apr 8.
Little is known about the similarities and differences in the clogging process of biliary and pancreatic stents. The aim of the study was to elucidate this process using scanning electron microscopy.
Scanning electron microscopy was performed in a consecutive series of 18 biliary and 10 pancreatic endoprostheses. The indication for stenting in the 18 patients (13 men, 5 women) with biliary stents was malignancy (n = 11), benign bile duct stenosis (n = 5), and biliary obstruction by bile duct stones (n = 2). The indication for stenting in the 10 patients (8 men, 2 women) with pancreatic stents was chronic pancreatitis with or without stenosis of the pancreatic duct.
The scanning electron microscopy study revealed a quite uniform pattern of the clogging material in biliary and pancreatic stents. The clogging material seemed to adhere to the inner stent surface by numerous tiny threads. The clogging material itself was also stabilized by tiny threads.
The occurrence of the tiny threads constitutes the central point in the clogging process in biliary and pancreatic stents. Inhibiting the formation of these threads or at least preventing adhesion to the inner stent surface might be the best option to improve stent patency.
关于胆管支架和胰管支架堵塞过程中的异同，目前所知甚少。本研究的目的是通过扫描电子显微镜来阐明这一过程。
对连续的18个胆管内支架和10个胰管内支架进行扫描电子显微镜检查。18例放置胆管支架的患者（13例男性，5例女性），放置支架的指征为恶性肿瘤（n = 11）、良性胆管狭窄（n = 5）和胆管结石引起的胆管梗阻（n = 2）。10例放置胰管支架的患者（8例男性，2例女性），放置支架的指征为伴有或不伴有胰管狭窄的慢性胰腺炎。
扫描电子显微镜研究显示，胆管支架和胰管支架内的堵塞物质模式相当一致。堵塞物质似乎通过许多细小的丝线附着在内支架表面。堵塞物质本身也由细小的丝线固定。
细小丝线的出现是胆管支架和胰管支架堵塞过程的关键所在。抑制这些丝线的形成或至少防止其附着在内支架表面，可能是改善支架通畅性的最佳选择。
