Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy.
Endoscopy. 2012 Apr;44(4):429-33. doi: 10.1055/s-0031-1291624. Epub 2012 Mar 1.
Endoscopic ultrasound-guided transmural drainage (EUS-GTD) has become the standard procedure for treating symptomatic pancreatic fluid collections. The aim of this series was to evaluate the efficacy and safety of covered self-expanding metal stent (CSEMS) placement for treating infected pancreatic fluid collections. From January 2007 to May 2010, 22 patients (18 M/4F; mean age 56.9) with infected pancreatic fluid collections (mean size, 13.2 cm) at two Italian centers were evaluated for EUS-GTD. In 20 of the 22 patients, EUS-GTD with CSEMS placement was indicated. Early complications occurred in two patients: one patient developed a superinfection, which was managed conservatively, and one experienced stent migration and superinfection, and was managed surgically. The CSEMSs were removed without difficulty in 18 patients after a median of 26 days, while stent removal failed in one patient due to inflammatory tissue ingrowth; instead it was removed during surgery performed for renal cancer. Clinical success was achieved without additional intervention in 17 patients during a mean follow-up of 610 days; only one symptomatic recurrence was observed. In our experience, EUS-GTD with CSEMS placement appears safe for the treatment of infected pancreatic fluid collections.
内镜超声引导经壁引流术（EUS-GTD）已成为治疗有症状胰腺液体积聚的标准程序。本系列的目的是评估覆盖自膨式金属支架（CSEMS）放置治疗感染性胰腺液体积聚的疗效和安全性。在 2007 年 1 月至 2010 年 5 月期间，两个意大利中心的 22 名（18 名男性/4 名女性；平均年龄 56.9）患有感染性胰腺液体积聚（平均大小 13.2cm）的患者接受了 EUS-GTD 评估。在 22 名患者中，有 20 名患者需要进行 EUS-GTD 联合 CSEMS 放置。两名患者出现早期并发症：一名患者发生继发感染，采用保守治疗；另一名患者出现支架迁移和继发感染，采用手术治疗。18 名患者的 CSEMS 在中位时间 26 天后被顺利取出，而 1 名患者由于炎症组织生长而导致支架取出失败，该患者随后因肾癌而行手术切除。在平均 610 天的随访中，17 名患者在无需额外干预的情况下获得了临床成功，仅观察到 1 例症状复发。根据我们的经验，EUS-GTD 联合 CSEMS 放置治疗感染性胰腺液体积聚是安全的。
