Horaguchi Jun, Fujita Naotaka, Noda Yutaka, Kobayashi Go, Ito Kei, Koshita Shinsuke, Kanno Yoshihide, Ogawa Takahisa
Department of Gastroenterology, Sendai City Medical Center, Japan.
Intern Med. 2011;50(19):2089-93. doi: 10.2169/internalmedicine.50.5466. Epub 2011 Oct 1.
Although reports on endosonography-guided biliary drainage (ESBD) have been increasing, only a few discuss deployment of a self-expandable metal stent (SEMS) in the first session.
To evaluate the safety and efficacy of ESBD with the one-step placement of a newly designed fully-covered SEMS.
Five patients with malignant biliary obstruction in whom one-step placement of an anti-migration designed SEMS in the first session of ESBD had been attempted between January 2007 and October 2009 were included in this study. Main outcome measurements were technical and clinical successes, early complications, and short-term results.
ESBD was attempted to bridge the extrahepatic bile duct and the duodenum and one-step SEMS placement was successful in all cases. There were no early complications related to ESBD and excellent biliary decompression was obtained in all cases. SEMS dysfunction such as stent migration and occlusion was not seen during the follow-up period (mean follow-up 138 days, range 102-184 days).
One-step placement of a fully-covered SEMS in ESBD is possibly a safe and effective treatment for biliary obstruction.
尽管关于内镜超声引导下胆道引流（ESBD）的报道不断增加，但只有少数报道讨论了在首次操作中置入自膨式金属支架（SEMS）的情况。
评估在ESBD中一步置入新设计的全覆膜SEMS的安全性和有效性。
本研究纳入了2007年1月至2009年10月期间尝试在ESBD首次操作中一步置入防移位设计的SEMS的5例恶性胆道梗阻患者。主要观察指标为技术成功率、临床成功率、早期并发症和短期结果。
尝试通过ESBD建立肝外胆管与十二指肠之间的通道，所有病例一步置入SEMS均获成功。未出现与ESBD相关的早期并发症，所有病例均实现了良好的胆道减压。随访期间（平均随访138天，范围102 - 184天）未发现SEMS功能障碍，如支架移位和堵塞。
在ESBD中一步置入全覆膜SEMS可能是治疗胆道梗阻的一种安全有效的方法。
