Ueda Takashi, Miyoshi Kouhei, Kegasawa Tadashi, Inoue Hirokazu, Fujita Minoru, Tatsumi Osamu, Fukui Hiroyuki
Dept. of Gastroenterology, Yao Municipal Hospital.
Gan To Kagaku Ryoho. 2011 Nov;38(12):1969-71.
We report five-metallic stent placement cases for malignant duodenal stenosis. Two of them received a placement of Ultraflex by over-the-wire (OTW) procedure, and the other three received a placement of WallFlex by through-the-scope (TTS) procedure. We assessed the baseline characteristic of the patient, procedural time and food intake after the stent placement for both OTW and TIS groups. OTW GROUP CASE 1: A 93-year-old woman with cancer of the ampulla of Vater, 60 min. in procedure time and low-residue diet after stent replacement. OTW GROUP CASE 2: A 76-year-old man with pancreatic cancer, 90 min. in procedure time and low-residue diet after stent replacement. TTS GROUP CASE 1: A 56-year-old man with recurrent postoperative bile duct cancer and gallbladder cancer, 16 min. in procedure time and full diet after stent replacement. TTS group case 2: A 79-year-old woman with pancreatic cancer, 40 min. in procedure time and liquids only after stent placement. TTS GROUP CASE 3: A 64-year-old woman with pancreatic cancer, 17 min. in procedure time and liquids only after stent placement. In comparison with OTW, TTS placement was much easier and it took a shorter procedural time. However, we consider that a selection of suitable stents and an assessment of the location for good food intake after stent placement are more important.
我们报告了5例恶性十二指肠狭窄金属支架置入病例。其中2例通过导丝（OTW）置入Ultraflex支架，另外3例通过经内镜（TTS）置入WallFlex支架。我们评估了OTW组和TTS组患者的基线特征、手术时间以及支架置入后的食物摄入量。OTW组病例1：一名93岁患有 Vater壶腹癌的女性，手术时间60分钟，支架置入后采用低渣饮食。OTW组病例2：一名76岁患有胰腺癌的男性，手术时间90分钟，支架置入后采用低渣饮食。TTS组病例1：一名56岁患有复发性术后胆管癌和胆囊癌的男性，手术时间16分钟，支架置入后可正常饮食。TTS组病例2：一名79岁患有胰腺癌的女性，手术时间40分钟，支架置入后仅可进食流食。TTS组病例3：一名64岁患有胰腺癌的女性，手术时间17分钟，支架置入后仅可进食流食。与OTW相比，TTS置入更容易，手术时间更短。然而，我们认为选择合适的支架以及评估支架置入后有利于食物摄入的位置更为重要。
