Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Gastrointest Endosc. 2013 May;77(5):809-14. doi: 10.1016/j.gie.2013.01.009. Epub 2013 Feb 26.
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.
To evaluate a newly developed, fully covered, self-expandable metal stent (FCSEMS) customized for cystogastrostomy.
Retrospective case series.
Tertiary-care academic medical centers and affiliated hospitals.
Nine patients who underwent endoscopic treatment of PFCs (5 with pseudocysts and 4 with walled-off pancreatic necrosis).
Stent deployment after endoscopic US-guided puncture. Irrigation and necrosectomy were performed at the discretion of the endoscopist.
Technical and clinical success rate, complications, and removability.
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%).
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.
The endoscopic approach that uses this new FCSEMS is feasible for the treatment of PFCs. However, further evaluation is required.
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。
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。
回顾性病例系列。
三级保健学术医疗中心和附属医院。
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)。
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。
技术和临床成功率、并发症和可移除性。
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%)。
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。
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。