Patil Rashmee, Ona Mel A, Papafragkakis Charilaos, Anand Sury, Duddempudi Sushil
Department of Internal Medicine, Mount Sinai Health Systems New York, New York (Rashmee Patil), USA.
Department of Gastroenterology and Hepatology, The Brooklyn Hospital Center Academic Affiliate of The Icahn School of Medicine at Mount Sinai Clinical Affiliate of The Mount Sinai Hospital Brooklyn, New York (Mel A. Ona, Sury Anand, Sushil Duddempudi), USA.
Ann Gastroenterol. 2016 Apr-Jun;29(2):162-7. doi: 10.20524/aog.2016.0001.
Acute cholecystitis and other clinical problems requiring gallbladder removal or drainage have conventionally been treated with surgery, endoscopic retrograde cholangiopancreatography or percutaneous transhepatic drainage of the gallbladder and/or extrahepatic bile duct. Patients unable to undergo these procedures due to functional status or anatomical anomalies are candidates for endoscopic ultrasound (EUS)-guided gallbladder drainage with stent placement. The aim of this review was to evaluate the technical feasibility and efficacy of EUS-guided placement of the recently developed lumen-apposing self-expandable metallic stent (LASEMS). A literature review was performed to identify the studies describing this technique. In this review article we have summarized case series or reports describing EUS-guided LASEMS placement. The indications, techniques, limitations and complications reported are discussed. A total of 78 patients were included across all studies described thus far in the literature. Studies have reported near 100% technical and clinical success rates in selected cases. No major complications were reported. EUS-guided gallbladder drainage and LASEMS placement can be a safe and effective alternative approach in the management of selected patients.
急性胆囊炎及其他需要切除胆囊或进行引流的临床问题，传统上采用手术、内镜逆行胰胆管造影术或经皮经肝胆囊和/或肝外胆管引流进行治疗。因功能状态或解剖异常而无法接受这些手术的患者，是内镜超声（EUS）引导下放置支架进行胆囊引流的候选对象。本综述的目的是评估EUS引导下放置最近开发的管腔贴附自膨式金属支架（LASEMS）的技术可行性和疗效。通过文献回顾来确定描述该技术的研究。在这篇综述文章中，我们总结了描述EUS引导下LASEMS放置的病例系列或报告。讨论了所报道的适应证、技术、局限性和并发症。文献中描述的所有研究共纳入了78例患者。研究报告在选定病例中技术成功率和临床成功率接近100%。未报告重大并发症。EUS引导下胆囊引流和LASEMS放置在特定患者的管理中可以是一种安全有效的替代方法。
