恶性肝门部梗阻的双侧金属支架置入术
Bilateral metallic stenting in malignant hilar obstruction.
作者信息
Lee Tae Hoon, Moon Jong Ho, Park Sang-Heum
机构信息
Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.
出版信息
Clin Endosc. 2014 Sep;47(5):440-6. doi: 10.5946/ce.2014.47.5.440. Epub 2014 Sep 30.
Abstract
Endoscopic palliative biliary drainage is considered as a gold standard treatment in advanced or inoperable hilar cholangiocarcinoma. Also, metal stents are preferred over plastic stents in patients with >3 months life expectancy. However, the endoscopic intervention of advanced hilar obstruction is often more challenging and complex than that of distal malignant biliary obstructions. In this literature review, we describe the issues commonly encountered during endoscopic unilateral (single) versus bilateral (multiple) biliary stenting for malignant hilar obstruction. Also, we provide technical guidance to improve the technical success rates and patient outcomes, focusing on bilateral metallic stenting techniques such as stent-in-stent or side-by-side deployment.
摘要
内镜下姑息性胆道引流被认为是晚期或无法手术切除的肝门部胆管癌的金标准治疗方法。此外，对于预期寿命大于3个月的患者，金属支架优于塑料支架。然而，晚期肝门部梗阻的内镜介入治疗通常比远端恶性胆道梗阻的治疗更具挑战性和复杂性。在这篇文献综述中，我们描述了在恶性肝门部梗阻的内镜单侧（单个）与双侧（多个）胆道支架置入过程中常见的问题。此外，我们提供技术指导以提高技术成功率和患者预后，重点关注双侧金属支架置入技术，如支架套叠或并排置入。
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本文引用的文献
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Technical tips and issues of biliary stenting, focusing on malignant hilar obstruction.胆管支架置入术的技术要点与问题，重点关注恶性肝门部梗阻
Clin Endosc. 2013 May;46(3):260-6. doi: 10.5946/ce.2013.46.3.260. Epub 2013 May 31.
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Endoscopic bilateral deployment of multiple metallic stents for malignant hilar biliary strictures.内镜下双侧置入多个金属支架治疗恶性肝门胆管狭窄。
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Side-by-side versus stent-in-stent deployment in bilateral endoscopic metal stenting for malignant hilar biliary obstruction.双侧内镜下金属支架置入术治疗恶性肝门部胆管梗阻时支架对置与支架内再置的比较。
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Metallic stents are more efficacious than plastic stents in unresectable malignant hilar biliary strictures: a randomized controlled trial.金属支架比塑料支架在不可切除的恶性肝门胆管狭窄中更有效：一项随机对照试验。
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