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一例罕见并发症所引发的胆管支架置入术后问题综述

A review of problems following insertion of biliary stents illustrated by an unusual complication.

作者信息

Bagul Atul, Pollard Cristina, Dennison Ashley R

机构信息

HPB Department, University Hospitals of Leicester, Leicester General Hospital, Gwendolen Road, Leicester, UK.

出版信息

Ann R Coll Surg Engl. 2010 May;92(4):W27-31. doi: 10.1308/147870810X12659688852239.

Abstract

INTRODUCTION

The management of obstructive jaundice resulting from both benign and malignant causes relies heavily on minimally invasive techniques and particularly with the insertion of biliary endoprostheses. Migration of these biliary stents is a well-documented problem and can result in a variety of complications including perforation, intra-abdominal sepsis, fistulae formation, obstruction and appendicitis.

METHODS

A literature search was performed using PubMed examining case reports, published abstracts and reviews to date (2009). In addition, we report a left groin abscess as a previously unreported complication following migration of a biliary endoprosthesis.

FINDINGS

Stent migration can lead to serious complications and produce significant morbidity and mortality. Symptomatic patients especially those with other co-morbid abdominal pathologies such as colonic diverticulae, parastomal hernia or abdominal hernias may be at an increased risk of perforation especially when straight plastic stents are used.

摘要

引言

由良性和恶性病因导致的梗阻性黄疸的治疗在很大程度上依赖于微创技术,尤其是胆道内支架置入术。这些胆道支架移位是一个有充分文献记载的问题,可导致多种并发症,包括穿孔、腹腔内感染、瘘管形成、梗阻和阑尾炎。

方法

利用PubMed进行文献检索,查阅病例报告、已发表的摘要和截至2009年的综述。此外,我们报告了一例左侧腹股沟脓肿,这是胆道内支架移位后一种先前未报告的并发症。

结果

支架移位可导致严重并发症,并造成显著的发病率和死亡率。有症状的患者,尤其是那些患有其他并存腹部病变(如结肠憩室、造口旁疝或腹疝)的患者,穿孔风险可能增加,尤其是在使用直塑料支架时。

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