Gastroenterology Unit, Medical Department, Hospital Tengku Ampuan Afzan, Jalan Tanah Putih, 25100 Kuantan, Pahang, Malaysia.
World J Gastroenterol. 2010 Jul 28;16(28):3597-600. doi: 10.3748/wjg.v16.i28.3597.
Postoperative biliary strictures are the most common cause of benign biliary stricture in Western countries, secondary to either operative injury or bile duct anastomotic stricture following orthotopic liver transplantation (OLT). Surgery or endoscopic interventions are the mainstay of treatment for benign biliary strictures. We aim to report the outcome of 2 patients with refractory anastomotic biliary stricture post-OLT, who had successful temporary placement of a prototype removable covered self-expandable metal stent (RCSEMS). These 2 patients (both men, aged 44 and 53 years) were given temporary placement of a prototype RCSEMS (8.5 Fr gauge delivery system, 8 mm x 40 mm stent dimensions) in the common bile duct across the biliary stricture. There was no morbidity associated with stent placement and removal in these 2 cases. Clinical parameters improved after the RCSEMS placement. Long-term biliary patency was achieved in both the patients. No further biliary intervention was required within 14 and 18 mo follow-up after stent removal.
术后胆道狭窄是西方国家最常见的良性胆道狭窄原因,继发于手术损伤或原位肝移植(OLT)后胆肠吻合口狭窄。手术或内镜介入是治疗良性胆道狭窄的主要方法。我们旨在报告 2 例 OLT 后难治性吻合口胆道狭窄患者的治疗结果,他们成功地临时放置了一种原型可移除覆盖自膨式金属支架(RCSEMS)。这 2 名患者(均为男性,年龄分别为 44 岁和 53 岁)在胆总管中临时放置了一种原型 RCSEMS(8.5Fr 输送系统,支架尺寸为 8mmx40mm),横跨狭窄部位。这 2 例患者支架放置和取出均无并发症。RCSEMS 放置后临床参数有所改善。在支架取出后 14 和 18 个月的随访中,患者的胆道均保持长期通畅,无需进一步胆道介入治疗。