Kaino Seiji, Sen-Yo Manabu, Shinoda Shuhei, Kawano Michitaka, Harima Hirofumi, Suenaga Shigeyuki, Sakaida Isao
Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, 1-1-1, Minami Kogushi, Ube, Yamaguchi, 755-8505, Japan.
Clin J Gastroenterol. 2017 Feb;10(1):68-72. doi: 10.1007/s12328-016-0694-z. Epub 2016 Oct 15.
Postoperative biliary strictures are usually complications of cholecystectomy. Endoscopic plastic stent prosthesis is generally undertaken for treating benign biliary strictures. Recently, fully covered metal stents have been shown to be effective for treating benign distal biliary strictures. We present the case of a 53-year-old woman with liver injury in which imaging studies showed a common hepatic duct stricture. Endoscopic retrograde cholangiopancreatography also confirmed the presence of a common hepatic duct stricture. Temporally fully covered metal stents with dilated diameters of 6 mm were placed in a side-by-side fashion in the left and right hepatic ducts, respectively. We removed the stents 2 months after their placement. Subsequent cholangiography revealed an improvement in the biliary strictures. Although we were apprehensive about the fully covered metal stents obstructing the biliary side branches, we noted that careful placement of the bilateral metal stents did not cause any complications. Side-by-side deployment of bilateral endoscopic fully covered metal stents can be one of the safe and effective therapies for postoperative biliary stricture.
术后胆管狭窄通常是胆囊切除术的并发症。内镜下塑料支架置入术一般用于治疗良性胆管狭窄。最近,全覆膜金属支架已被证明对治疗良性远端胆管狭窄有效。我们报告一例53岁肝损伤女性病例,影像学检查显示肝总管狭窄。内镜逆行胰胆管造影术也证实存在肝总管狭窄。分别在左右肝管以并排方式置入直径扩张至6毫米的临时性全覆膜金属支架。支架置入2个月后取出。随后的胆管造影显示胆管狭窄有所改善。尽管我们担心全覆膜金属支架会阻塞胆管侧支,但我们注意到双侧金属支架的仔细放置并未引起任何并发症。双侧内镜下全覆膜金属支架并排置入可成为术后胆管狭窄安全有效的治疗方法之一。