聚乙稀和Sof-Flex材料支架治疗慢性胰腺炎患者的胰管变化：一项盲法比较研究

Pancreatic Duct Changes in Patients With Chronic Pancreatitis Treated With Polyethylene and Sof-Flex Material Stents: A Blinded Comparison.

作者信息

Samuelson Andrew, Zeligman Bernard, Russ Paul, Austin Gregory L, Yen Roy, Shah Raj J

机构信息

From the *Division of Gastroenterology and Hepatology, Department of Internal Medicine, and †Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, CO.

出版信息

Pancreas. 2016 Feb;45(2):281-5. doi: 10.1097/MPA.0000000000000471.

DOI:10.1097/MPA.0000000000000471

PMID:26752255

Abstract

OBJECTIVES

Pancreatic stenting is used to improve painful, obstructive chronic pancreatitis. Data suggest that polyethylene stents (PESs) cause stent-associated changes (SACs). Whether a stent composed of more flexible material (Sof-Flex stent [SFS]) is associated with less SAC is unknown.

METHODS

This study is a retrospective study of patients who underwent pancreatic duct stenting of at least 1 PES and 1 SFS on separate examinations and had a follow-up pancreatogram at the time of stent removal. The main outcome measurements were assessed for SAC on follow-up pancreatogram and interpreted by 2 radiologists blinded to the clinical data.

RESULTS

Stent-associated changes were noted with 28% (13/47) of SFS and with 25% (13/52) of PES (P = 0.65). For 10F stent subgroups, SACs were seen with 25% (6/24) of the SFS compared with 50% (2/4) in the PES. Thirty percent (7/23) of the 8.5F SFS subgroup had SACs versus 29% (2/7) in the PES group (P = 0.887) for 8.5F + 10F combined comparison.

CONCLUSIONS

In patients who have had polyethylene or SFSs of varying sizes, approximately 1 in 4 have SACs. Despite the use of a softer stent material for therapeutic stenting, the rate of SACs in the 8.5F and 10F subgroups seems similar between the 2 materials and design.

摘要

目的

胰腺支架置入术用于改善疼痛性、梗阻性慢性胰腺炎。数据表明，聚乙烯支架（PES）会引起支架相关改变（SAC）。由更柔软材料制成的支架（Sof-Flex支架[SFS]）是否与较少的SAC相关尚不清楚。

方法

本研究是一项回顾性研究，纳入在不同检查中至少置入1个PES和1个SFS并在支架取出时进行了随访胰管造影的患者。主要结局指标在随访胰管造影时评估SAC，并由2名对临床数据不知情的放射科医生进行解读。

结果

在SFS中，28%（13/47）出现支架相关改变，在PES中，25%（13/52）出现支架相关改变（P = 0.65）。对于10F支架亚组，SFS中有25%（6/24）出现SAC，而PES中有50%（2/4）出现SAC。8.5F SFS亚组中有30%（7/23）出现SAC，而PES组中为29%（2/7）（8.5F + 10F联合比较，P = 0.887）。