胰十二指肠切除术后患者胰管空肠吻合支架向胆管内移位
Migration of Internal Pancreaticojejunostomy Stents into the Bile Ducts in Patients Undergoing Pancreatoduodenectomy.
作者信息
Park So Hyun, Kim Jin Hee, Noh Seung Yeon, Byun Jae Ho, Lee Seung Soo, Kim Hyoung Jung, Park Seong Ho, Lee Sung Koo, Hwang Dae Wook, Kim Song Cheol, Han Duck Jong, Lee Moon-Gyu
机构信息
Department of Radiology and Research Institute of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, 88 Olympic-ro, 43-gil, Songpa-Gu, Seoul, 138-736, South Korea.
Department of Internal Medicine, Asan Medical Center, College of Medicine, University of Ulsan, 88 Olympic-ro, 43-gil, Songpa-Gu, Seoul, 138-736, South Korea.
出版信息
J Gastrointest Surg. 2015 Nov;19(11):1995-2002. doi: 10.1007/s11605-015-2906-0. Epub 2015 Aug 6.
PURPOSE
To investigate the incidence, complications, and risk factors of the migration of internal pancreaticojejunostomy (PJ) stents into the bile ducts in patients undergoing pancreatoduodenectomy.
METHODS
Postoperative computed tomography (CT) and clinical data of 802 patients with CT-detectable internal PJ stents were reviewed to assess the occurrence of stent migration into the bile ducts and stent-induced complications with their clinical significance. Risk factors for stent migration and stent-induced complications were determined.
RESULTS
Stent migration into the bile ducts occurred in 135 patients (16.8 %); 40 of these (29.6 %) showed stent-induced complications including bile duct stricture, stone, and liver abscess. Clinically significant complications were identified in only eight patients. Neither the stent length nor diameter was associated with stent migration. A small stent diameter, peripheral location of the stent, absence of stent remigration from the bile ducts to the intestine, and longer stent retention time in the bile ducts were risk factors of stent-induced complications.
CONCLUSIONS
The incidence of internal PJ stent migration into the bile ducts was 16.8 %. Migrated stents frequently caused complications, although they were mostly subclinical. Stent-induced complications were associated with stent diameter and location, stent remigration to the intestine, and stent retention time in the bile ducts.
目的
探讨胰十二指肠切除术后患者胰管空肠吻合术（PJ）内支架移入胆管的发生率、并发症及危险因素。
方法
回顾802例CT可检测到PJ内支架患者的术后计算机断层扫描（CT）及临床资料，以评估支架移入胆管的发生率及支架相关并发症及其临床意义。确定支架移位和支架相关并发症的危险因素。
结果
135例患者（16.8%）发生支架移入胆管；其中40例（29.6%）出现支架相关并发症，包括胆管狭窄、结石及肝脓肿。仅8例患者出现具有临床意义的并发症。支架长度和直径均与支架移位无关。支架直径小、支架位于外周、支架未从胆管再移入肠道以及支架在胆管内留置时间较长是支架相关并发症的危险因素。
结论
PJ内支架移入胆管的发生率为16.8%。尽管大多数移位支架引起的并发症为亚临床情况，但仍常导致并发症。支架相关并发症与支架直径和位置、支架再移入肠道以及支架在胆管内的留置时间有关。
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