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新型全覆膜金属支架治疗胰腺积液的初步报告。

Preliminary report on a new, fully covered, metal stent designed for the treatment of pancreatic fluid collections.

机构信息

Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

出版信息

Gastrointest Endosc. 2013 May;77(5):809-14. doi: 10.1016/j.gie.2013.01.009. Epub 2013 Feb 26.

DOI:10.1016/j.gie.2013.01.009
PMID:23453183
Abstract

BACKGROUND

Endoscopic transluminal treatment of pancreatic fluid collections (PFC) has been reported as an effective alternative approach to surgical treatment. A wide, short stent with an anti-migration system has been developed.

OBJECTIVE

To evaluate a newly developed, fully covered, self-expandable metal stent (FCSEMS) customized for cystogastrostomy.

DESIGN

Retrospective case series.

SETTING

Tertiary-care academic medical centers and affiliated hospitals.

PATIENTS

Nine patients who underwent endoscopic treatment of PFCs (5 with pseudocysts and 4 with walled-off pancreatic necrosis).

INTERVENTION

Stent deployment after endoscopic US-guided puncture. Irrigation and necrosectomy were performed at the discretion of the endoscopist.

MAIN OUTCOME MEASUREMENTS

Technical and clinical success rate, complications, and removability.

RESULTS

The FCSEMS was inserted successfully in all cases (9/9, 100%). Clinical success was achieved in 7 of 9 cases (77.8%). No early complications associated with the procedure were observed. Late complications were observed in 2 cases (bleeding and asymptomatic migration). The FCSEMS was removed without any complications in all 6 cases where it was attempted after the procedure had been completed (100%).

LIMITATIONS

This was a retrospective evaluation of a small number of cases. The FCSEMS was always inserted via the transgastric route. Follow-up duration was short.

CONCLUSION

The endoscopic approach that uses this new FCSEMS is feasible for the treatment of PFCs. However, further evaluation is required.

摘要

背景

内镜经黏膜下隧道肿瘤切除术(STER)已被报道为一种有效的替代手术治疗方法。一种带有抗迁移系统的宽短支架已被开发出来。

目的

评估一种新开发的、完全覆盖的、自扩张金属支架(FCSEMS),专门用于囊肿胃吻合术。

设计

回顾性病例系列。

设置

三级保健学术医疗中心和附属医院。

患者

9 名接受内镜治疗胰腺液体积聚(PFC)的患者(5 例假性囊肿和 4 例胰腺包裹性坏死)。

干预

内镜超声引导下穿刺后支架放置。冲洗和坏死组织清除术由内镜医生决定是否进行。

主要观察指标

技术和临床成功率、并发症和可移除性。

结果

所有病例(9/9,100%)均成功插入 FCSEMS。7 例(77.8%)达到临床成功。未观察到与该操作相关的早期并发症。2 例(出血和无症状迁移)观察到晚期并发症。所有 6 例尝试移除 FCSEMS 的病例均成功,无任何并发症(100%)。

局限性

这是对少数病例的回顾性评估。FCSEMS 始终通过经胃途径插入。随访时间短。

结论

使用这种新的 FCSEMS 的内镜方法可用于治疗 PFC。然而,需要进一步评估。

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