Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap 2-dong, Songpa-gu, Seoul 138-736, Republic of Korea.
AJR Am J Roentgenol. 2012 Dec;199(6):W761-6. doi: 10.2214/AJR.12.8575.
The purpose of this article is to assess the technical feasibility and clinical effectiveness of the placement of partially covered self-expandable dual stents in patients with afferent loop syndrome.
Data from 13 consecutive patients who had undergone partially covered dual stent placement for afferent loop syndrome after various types of surgery were retrospectively analyzed. Nine patients underwent stent placement via the percutaneous transhepatic biliary drainage tract, and four patients underwent placement via the peroral route. A total of 16 stents were used in this study (i.e., 15 dual stents and one fully covered esophageal stent).
The route of stent insertion was determined on the basis of each patient's general condition, the site of obstruction, anatomic variations, and associated symptoms. Stent placement was technically successful in all patients. After stent placement, 12 of 13 patients experienced normalization of their abnormal biliary laboratory findings and decompression of the dilated bowel loop, whereas the remaining patient showed no change. This patient had to undergo the additional treatment of surgical jejunojejunostomy. No procedure-related complications occurred in any patients enrolled in this study.
Placement of partially covered dual stents appears to be a promising technique that may offer successful palliation for patients who develop afferent loop syndrome after various types of surgery.
本文旨在评估在各种类型手术后发生输入袢综合征的患者中放置部分覆膜自膨式双支架的技术可行性和临床疗效。
回顾性分析了 13 例连续接受部分覆膜双支架置入术治疗输入袢综合征的患者的数据。9 例患者经经皮经肝胆道引流途径行支架置入，4 例患者经口途径行支架置入。本研究共使用 16 个支架（即 15 个双支架和 1 个全覆膜食管支架）。
支架插入途径根据患者的一般情况、梗阻部位、解剖变异和相关症状确定。所有患者的支架置入均获得技术成功。支架置入后，13 例患者中的 12 例异常胆道实验室检查结果和扩张肠袢得到减压恢复正常，而其余 1 例患者无变化。该患者需要接受额外的手术空肠空肠吻合术治疗。本研究纳入的患者均未发生与手术相关的并发症。
对于各种类型手术后发生输入袢综合征的患者，放置部分覆膜双支架似乎是一种有前途的技术，可能为患者提供成功的姑息治疗。
