Téllez-Ávila Félix Ignacio, Villalobos-Garita Alvaro, Ramírez-Luna Miguel Ángel
Félix Ignacio Téllez-Ávila, Miguel Ángel Ramírez-Luna, Department of Endoscopy, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, CP 14000, México.
World J Gastrointest Endosc. 2013 Jun 16;5(6):297-9. doi: 10.4253/wjge.v5.i6.297.
The development of pseudocysts in patients with chronic pancreatitis has been reported in 23%-60% of cases and drainage is indicated when they become symptomatic. Endoscopic ultrasound-guided drainage with the placement of plastic or metallic stents to create a cystogastric anastomosis has been shown to be a reliable and efficacious maneuver. Metallic stent use appears to be a safe and effective alternative that shortens the length of time of the procedure and maintains a greater diameter in the cystogastric communication. However, important migration rates have been reported. The use of new metallic stents that are specially designed to prevent migration represents a promising development in the treatment of these group of patients that appears to be safe and effective for pseudocyst drainage and could importantly reduce migration rates, while at the same time having the advantage of a single step procedure and a larger fistula diameter in the endoscopic cystogastric anastomosis.
据报道,慢性胰腺炎患者假性囊肿的发生率为23% - 60%,出现症状时需进行引流。内镜超声引导下放置塑料或金属支架以建立囊肿胃吻合术进行引流已被证明是一种可靠且有效的操作。使用金属支架似乎是一种安全有效的替代方法,可缩短手术时间,并在囊肿胃通道中保持更大的直径。然而,已有报道称金属支架有较高的移位率。专门设计用于防止移位的新型金属支架的使用,在这类患者的治疗中是一个有前景的进展,似乎对假性囊肿引流安全有效,且可显著降低移位率,同时具有一步操作的优势,在内镜囊肿胃吻合术中可形成更大的瘘管直径。