Prachayakul Varayu, Aswakul Pitulak
Varayu Prachayakul, Siriraj GI Endoscopy Center, Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
World J Gastroenterol. 2015 Mar 7;21(9):2725-30. doi: 10.3748/wjg.v21.i9.2725.
To assess the feasibility and safety of the use of soehendra stent retriever as a new technique for biliary access in endoscopic ultrasound-guided biliary drainage.
The medical records and endoscopic reports of the patients who underwent endoscopic ultrasound-guided biliary drainage (EUS-BD) owing to failed endoscopic retrograde cholangiopancreatography in our institute between June 2011 and January 2014 were collected and reviewed. All the procedures were performed in the endoscopic suite under intravenous sedation with propofol and full anaesthetic monitoring. Then we used the Soehendra stent retriever as new equipment for neo-tract creation and dilation when performing EUS-BD procedures. The patients were observed in the recovery room for 1-2 h and transferred to the regular ward, patients' clinical data were reviewed and analysed, clinical outcomes were defined by using several different criteria. Data were analysed by using SPSS 13 and presented as percentages, means, and medians.
A total of 12 patients were enrolled. The most common indications for EUS-BD in this series were failed common bile duct cannulation, duodenal obstruction, failed selective intrahepatic duct cannulation, and surgical altered anatomy for 50%, 25%, 16.7%, and 8.3%, respectively. Seven patients underwent EUS-guided hepaticogastrostomy (58.3%), and 5 underwent EUS-guided choledochoduodenostomy (41.7%). The technical success rate was 100%, while the clinical success rate was 91.7%. Major and minor complications occurred in 16.6% and 33.3% of patients, respectively, but there were no procedure-related death.
Soehendra stent retriever could be used as an alternative instrument for biliary access in endoscopic ultrasound guided biliary drainage.
评估使用索恩德拉支架回收器作为内镜超声引导下胆道引流中一种新的胆道通路建立技术的可行性和安全性。
收集并回顾了2011年6月至2014年1月期间在我院因内镜逆行胰胆管造影失败而接受内镜超声引导下胆道引流（EUS-BD）患者的病历和内镜报告。所有操作均在内镜检查室进行，静脉注射丙泊酚镇静并进行全面麻醉监测。然后在进行EUS-BD操作时，我们使用索恩德拉支架回收器作为建立和扩张新通道的新设备。患者在恢复室观察1-2小时后转至普通病房，对患者的临床资料进行回顾和分析，使用多种不同标准定义临床结局。数据采用SPSS 13进行分析，并以百分比、均值和中位数表示。
共纳入12例患者。本系列中EUS-BD最常见的适应证分别为胆总管插管失败、十二指肠梗阻、选择性肝内胆管插管失败以及手术改变解剖结构，比例分别为50%、25%、16.7%和8.3%。7例患者接受了内镜超声引导下肝胃吻合术（58.3%），5例接受了内镜超声引导下胆总管十二指肠吻合术（41.7%）。技术成功率为100%，而临床成功率为91.7%。分别有16.6%和33.3%的患者发生了严重和轻微并发症，但无与操作相关的死亡病例。
索恩德拉支架回收器可作为内镜超声引导下胆道引流中胆道通路建立的替代器械。
