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经皮经肝使用可回收覆膜支架治疗良性胆道狭窄患者:68 例患者的中期结果。

Percutaneous transhepatic treatment using retrievable covered stents in patients with benign biliary strictures: mid-term outcomes in 68 patients.

机构信息

Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 86, Asanbyeongwon-gil, Songpa-gu, Seoul, 138-736, Korea,

出版信息

Dig Dis Sci. 2013 Nov;58(11):3270-9. doi: 10.1007/s10620-013-2784-9. Epub 2013 Jul 17.

Abstract

BACKGROUND

Percutaneous balloon dilation of benign biliary stricture has been the most widely used alternative to endoscopic treatment; however, the rate of recurrence has varied from 15 to 44 %. Recently, several investigators have reported that percutaneous transhepatic placement of retrievable covered stents is feasible for the treatment of benign biliary strictures. However, these studies had only a small number of patients and had short follow-up periods.

AIM

The purpose of this study was to investigate the mid-term outcomes of a retrievable covered stent for treatment of benign biliary strictures.

METHODS

We retrospectively assessed 68 patients who underwent percutaneous transhepatic placement and removal of a retrievable covered stent between March 2007 and November 2012, for treatment of benign biliary strictures. Forty-two patients had not previously undergone interventional treatment, whereas 26 had recurrent or refractory strictures despite previous percutaneous procedures.

RESULTS

Placement of the retrievable covered stents was technically successful in all patients. Stent migration occurred in 11 (16.2 %) patients. The mean indwelling period of drainage catheter and stent were 5.8 months (range, 3-22.5 months) and 3 months (range, 2-6.5 months), respectively. Clinical success was achieved in 59 (86.8 %) patients. During the mean follow-up of 36 months (range, 8.5-65 months), 12 (20 %) of 60 patients had recurrence of clinically significant strictures. The primary patency rates at 1, 2, 3, 4, and 5 years were 91, 89, 76, 68, and 68 %, respectively.

CONCLUSION

Mid-term outcomes suggested that percutaneous treatment of benign biliary strictures using a retrievable covered stent was a clinically effective method.

摘要

背景

经皮球囊扩张术已成为治疗良性胆道狭窄的首选方法,然而其复发率为 15%至 44%。最近,一些研究人员报告称,经皮经肝途径放置可回收覆盖支架是治疗良性胆道狭窄的一种可行方法。然而,这些研究的患者数量较少,随访时间较短。

目的

本研究旨在探讨可回收覆盖支架治疗良性胆道狭窄的中期疗效。

方法

回顾性分析 2007 年 3 月至 2012 年 11 月期间,68 例因良性胆道狭窄行经皮经肝途径放置和取出可回收覆盖支架的患者。42 例患者此前未接受介入治疗,26 例患者为既往经皮介入治疗后复发或难治性狭窄。

结果

所有患者均成功放置可回收覆盖支架。11 例(16.2%)患者出现支架移位。引流管和支架的平均留置时间分别为 5.8 个月(3-22.5 个月)和 3 个月(2-6.5 个月)。59 例(86.8%)患者获得临床成功。在平均 36 个月(8.5-65 个月)的随访期间,60 例中有 12 例(20%)患者出现临床显著狭窄的复发。1、2、3、4 和 5 年的主要通畅率分别为 91%、89%、76%、68%和 68%。

结论

中期结果表明,经皮经肝途径使用可回收覆盖支架治疗良性胆道狭窄是一种有效的临床方法。

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