Department of Gastroenterology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Japan.
Dig Endosc. 2013 May;25 Suppl 2:52-7. doi: 10.1111/den.12069.
Endoscopic biliary drainage with biliary stent placement is the treatment of choice for palliation in patients with malignant biliary obstruction caused by unresectable neoplasms. Various biliary stent designs have become available, but lack of a clear consensus persists on the use of covered versus uncovered metal stents in malignant distal bile duct obstructions, and plastic versus metal stents. In 2012, the European Society of Gastrointestinal Endoscopy indicated guidelines for biliary stenting. Accordingly, the consensus meeting for biliary stenting was held at the Endoscopic Forum Japan 2012, and four selected statements related to stent placement for distal malignant biliary obstruction were discussed to produce a consensus. Two of four statements (related to the usefulness of self-expandable metallic stents, and reintervention after stenting) were agreed upon by almost all participants. Nevertheless, our opinions were divided on the other two statements (necessity of sphincterotomy for stenting, and covered metal stent versus uncovered metal stent). We herein report the results of the meeting, and present proposed new statements via discussion.
经内镜胆道引流术联合胆道支架置入术是治疗无法切除的肿瘤引起的恶性胆道梗阻的姑息疗法。目前有多种胆道支架设计，但在恶性远端胆管梗阻中，覆膜与非覆膜金属支架的应用以及塑料支架与金属支架的选择仍缺乏明确共识。2012 年，欧洲胃肠道内镜学会发布了胆道支架置入指南。因此，在 2012 年日本内镜论坛上举行了胆道支架置入共识会议，讨论了与远端恶性胆道梗阻支架置入相关的 4 个精选声明，以达成共识。这 4 个声明中的 2 个（与自膨式金属支架的有用性以及支架置入后的再次干预相关）几乎得到了所有与会者的认可。然而，对于另外 2 个声明（支架置入时是否需要括约肌切开术以及覆膜金属支架与非覆膜金属支架的选择），我们的意见存在分歧。本文报告了会议的结果，并通过讨论提出了新的建议声明。
