Bapaye Amol, Itoi Takao, Kongkam Pradermchai, Dubale Nachiket, Mukai Shuntaro
Department of Digestive Diseases and Endoscopy, Deenanath Mangeshkar Hospital and Research Center, Pune, India.
Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
Dig Endosc. 2015 May;27(4):499-504. doi: 10.1111/den.12421. Epub 2015 Feb 6.
Endoscopic transmural drainage (ETMD) of peripancreatic fluid collections (PFC) is an effective alternative to surgical drainage. Conventional drainage using plastic stents has its limitations. A wide-bore short-length wide flange fully covered self-expandable metallic stent (FCSEMS) has recently been developed. The present study evaluates the efficacy of this new FCSEMS for ETMD of PFC.
This was a retrospective, multicenter study. Patients with PFC undergoing endoscopic ultrasound (EUS)-guided drainage of PFC using specially designed FCSEMS were included. Parameters evaluated were technical success of stent placement, clinical success as defined by resolution of PFC without any further surgical intervention, ability to carry out endoscopic necrosectomy, complications and feasibility of endoscopic stent removal.
Twenty-one PFC in 19 patients were drained using FCSEMS. Technical and clinical success for drainage was seen in all patients (100%). Endoscopic necrosectomy was carried out in seven (33%) PFC. Complications occurred in two patients (10.5%). Stents could be endoscopically removed in all patients (100%).
The new specially designed FCSEMS is safe and effective for drainage of PFC. Necrosectomy can be carried out through the stent. Stent can be removed endoscopically at the end of the treatment period.
胰腺周围液体积聚（PFC）的内镜下经壁引流（ETMD）是手术引流的一种有效替代方法。使用塑料支架的传统引流存在局限性。一种大口径、短长度、宽凸缘的全覆膜自膨式金属支架（FCSEMS）最近已被研发出来。本研究评估这种新型FCSEMS用于PFC的ETMD的疗效。
这是一项回顾性多中心研究。纳入了接受使用特殊设计的FCSEMS进行内镜超声（EUS）引导下PFC引流的PFC患者。评估的参数包括支架置入的技术成功率、定义为PFC消退且无需进一步手术干预的临床成功率、进行内镜下坏死组织清除术的能力、并发症以及内镜下取出支架的可行性。
19例患者的21处PFC使用FCSEMS进行了引流。所有患者（100%）引流的技术和临床成功率均可见。7处（33%）PFC进行了内镜下坏死组织清除术。2例患者（10.5%）发生了并发症。所有患者（100%）的支架均可通过内镜取出。
新型特殊设计的FCSEMS用于PFC引流是安全有效的。可通过支架进行坏死组织清除术。治疗期结束时可通过内镜取出支架。
