胰十二指肠切除术后门静脉狭窄的支架置入术
Stent Placement for Portal Vein Stenosis After Pancreaticoduodenectomy.
作者信息
Hiyoshi Masahide, Fujii Yoshiro, Kondo Kazuhiro, Imamura Naoya, Nagano Motoaki, Ohuchida Jiro
机构信息
Department of Surgical Oncology and Regulation of Organ Function, Miyazaki University School of Medicine, 5200 Kihara, Kiyotake, Miyazaki, Japan,
出版信息
World J Surg. 2015 Sep;39(9):2315-22. doi: 10.1007/s00268-015-3094-5.
BACKGROUND
Portal vein (PV) stenosis is a worrisome late complication following pancreaticoduodenectomy (PD) that causes intestinal bleeding from varices, which must be diagnosed correctly and treated promptly. Recent reports advocate the usefulness of stent placement to improve PV stenosis.
METHODS
We evaluated the cause, diagnosis, and treatment method of PV stenosis after PD and the duration of stent patency in our institution.
RESULTS
Intestinal bleeding caused by PV stenosis occurred in 5 (2.4%) of 205 patients. A computed tomography scan was useful to diagnose this complication. Four of 5 patients with PV stenosis underwent percutaneous transhepatic PV stent placement. The duration of stent patency was 21-41 months, and no rebleeding occurred.
CONCLUSIONS
Percutaneous stent placement is viable, less invasive option than laparotomy for the management of PV stenosis after PD.
背景
门静脉狭窄是胰十二指肠切除术后令人担忧的晚期并发症，可导致曲张静脉引起的肠道出血，必须正确诊断并及时治疗。最近的报告主张支架置入对改善门静脉狭窄有用。
方法
我们评估了本机构胰十二指肠切除术后门静脉狭窄的病因、诊断、治疗方法及支架通畅时间。
结果
205例患者中有5例（2.4%）发生门静脉狭窄所致肠道出血。计算机断层扫描有助于诊断此并发症。5例门静脉狭窄患者中有4例接受了经皮经肝门静脉支架置入术。支架通畅时间为21至41个月，未再出血。
结论
对于胰十二指肠切除术后门静脉狭窄的处理，经皮支架置入术是一种可行的、比剖腹手术侵入性小的选择。
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