Lu Yi, Jin Zheng, Wu Jia-Chuan, Bie Li-Ke, Gong Biao
Digestive Endoscopy Center, Department of Gastroenterology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.
Gastroenterol Res Pract. 2015;2015:485980. doi: 10.1155/2015/485980. Epub 2015 Mar 31.
Background. There were scarce trials concerning the treatments and outcomes of proximal pancreatic stent migration. Herein, we did a retrospective study to discuss this problem from an endoscopist's point of view. Patients and Methods. From January 2009 to June 2014, patients with proximally migrated pancreatic duct stents were identified. Their clinical information was viewed. Retrieval techniques, success rates, and adverse events were analyzed. Results. A total of 36 procedures were performed in 34 patients; the median age of the patients was 53 years, with 17 males and 17 females. Eight patients' pancreatic duct stents could still be seen in the major or minor papilla and were pulled out with a snare forceps or a grasping forceps; in the remaining 28 procedures, the management was somewhat thorny; the retrieval called for several devices. Final success was achieved in 31 patients. No adverse event was observed in the process of ERCP procedures, 5 patients developed post-ERCP pancreatitis (PEP), 1 patient got infection, and 1 patient had haemorrhage. Conclusions. Endoscopic retrieval of migrated pancreatic stent is safe and less invasive; nonetheless, attention should be paid so as to reduce the incidence and degree of related adverse events, especially PEP.
背景。关于近端胰管支架移位的治疗及预后的试验较少。在此，我们从内镜医师的角度进行了一项回顾性研究来探讨这个问题。
患者与方法。2009年1月至2014年6月，确定近端胰管支架移位的患者。查看他们的临床信息。分析取出技术、成功率及不良事件。
结果。34例患者共进行了36次操作；患者的中位年龄为53岁，男性17例，女性17例。8例患者的胰管支架仍可在主乳头或副乳头看到，用圈套器或抓取钳取出；在其余28次操作中，处理有些棘手；取出需要多种器械。31例患者最终成功取出。在ERCP操作过程中未观察到不良事件，5例患者发生了ERCP术后胰腺炎（PEP），1例患者发生感染，1例患者出血。
结论。内镜下取出移位的胰管支架是安全且侵入性较小的；尽管如此，应予以关注以降低相关不良事件尤其是PEP的发生率和严重程度。
