Department of Gastroenterology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China.
Gastroenterol Res Pract. 2014;2014:193562. doi: 10.1155/2014/193562. Epub 2014 Jun 11.
Aims. We attempted to establish some guidelines for the selection of transmural stents during endoscopic drainage of PFCs by retrospective review of the clinical data obtained from three tertiary hospitals. Patients and Methods. Clinical data of 93 patients with attempted endoscopic drainage of symptomatic PFCs were obtained through chart review and prospective follow-up. Results. Treatment success for acute pseudocyst (n = 67), chronic pseudocyst (n = 9), and WOPN (n = 17) was 95.3%, 100%, and 88.2%, respectively (P = 0.309). Clinical success for single-stent drainage was 93.9% (46/49) versus 97.4% (37/38) for multiple-stent drainage (P = 0.799). Secondary infection for single-stent drainage was 18.4% (9/49) versus 5.3% (2/38) for multiple-stent drainage (P = 0.134). Secondary infection for stent diameter less than or equal to 8.5 F was 3.4% (1/29) versus 17.2% (10/58) for stent diameter larger than or equal to 10 F (P = 0.138). Conclusion. EUS-guided transmural drainage is an effective therapy for PFCs. Single-stent transmural drainage of PFCs is enough and does not seem to influence clinical success. The number or diameter of stents does not seem to be associated with secondary infection.
目的。我们试图通过回顾三家三级医院获得的临床数据,为内镜引流胰腺假性囊肿(PFCs)时选择经壁支架建立一些指南。
患者和方法。通过病历回顾和前瞻性随访,获取了 93 例有症状 PFCs 尝试内镜引流患者的临床数据。
结果。急性假性囊肿(n = 67)、慢性假性囊肿(n = 9)和 WOPN(n = 17)的治疗成功率分别为 95.3%、100%和 88.2%(P = 0.309)。单支架引流的临床成功率为 93.9%(46/49),而多支架引流为 97.4%(37/38)(P = 0.799)。单支架引流的继发性感染率为 18.4%(9/49),而多支架引流为 5.3%(2/38)(P = 0.134)。支架直径小于或等于 8.5F 的继发性感染率为 3.4%(1/29),而支架直径大于或等于 10F 的继发性感染率为 17.2%(10/58)(P = 0.138)。
结论。EUS 引导下经壁引流是治疗 PFCs 的有效方法。PFCs 的单支架经壁引流已经足够,似乎不会影响临床成功率。支架的数量或直径似乎与继发性感染无关。