Sohn Se Hoon, Park Jae Hyun, Kim Kook Hyun, Kim Tae Nyeun
Se Hoon Sohn, Jae Hyun Park, Kook Hyun Kim, Tae Nyeun Kim, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu 42415, South Korea.
World J Gastroenterol. 2017 Jan 28;23(4):622-628. doi: 10.3748/wjg.v23.i4.622.
To evaluate complications and management outcomes of retained long-term plastic biliary stents.
Endoscopic plastic biliary stent placement was performed in 802 patients at Yeungnam University Hospital between January 2000 and December 2014. Follow-up loss with a subsequently forgotten stent for more than 12 mo occurred in 38 patients. We retrospectively examined the cause of biliary stent insertion, status of stents, complications associated with biliary stents and management outcomes of long-term plastic biliary stents. Continuous variables were analyzed using the test. Observed frequencies in subsets of the study population were compared using Fisher's exact test and χ tests. Statistical significance was defined as < 0.05 (two-tailed).
Mean age of patients was 73.7 ± 12 years and male-to-female ratio was 2.2:1. Indications of plastic biliary stent insertion were bile duct stones (63.2%, 24/38) and benign bile duct stricture (52.6%, 20/38). Mean duration of retained plastic stent was 22.6 ± 12.2 mo, and in 10 cases (26.3%), stents were retained for more than 24 mo. Common bile duct (CBD) stones or sludge were found in most cases (92.1%, 35/38). The most common complication was acute cholangitis (94.7%, 36/38). Stent removal by endoscopic approach was successfully performed in 92.1% (35/38) of the cases. In 3 cases, an additional plastic stent was inserted alongside the previous stent due to failure of the stent removal. Endoscopic removal of bile duct stones was successful in 73.7% (28/38) of the cases. When patients were divided into two groups by duration of stent placement (12 to 24 mo over 24 mo), there were no differences in the development of cholangitis, presence of biliary stones, and success rate of endoscopic removal of stones and biliary stents.
The most common complication of retained long-term plastic biliary stents was acute cholangitis associated with CBD stones. Endoscopic management was successfully performed in most cases.
评估长期留置塑料胆管支架的并发症及处理结果。
2000年1月至2014年12月期间，802例患者在庆南大学医院接受了内镜下塑料胆管支架置入术。38例患者出现随访失访且随后遗忘支架超过12个月的情况。我们回顾性研究了胆管支架置入的原因、支架状态、与胆管支架相关的并发症以及长期塑料胆管支架的处理结果。连续变量采用t检验进行分析。研究人群亚组中的观察频率采用Fisher精确检验和χ²检验进行比较。统计学显著性定义为P<0.05（双侧）。
患者的平均年龄为73.7±12岁，男女比例为2.2:1。塑料胆管支架置入的指征为胆管结石（63.2%，24/38）和良性胆管狭窄（52.6%，20/38）。塑料支架的平均留置时间为22.6±12.2个月，10例（26.3%）患者的支架留置时间超过24个月。大多数病例（92.1%，35/38）发现胆总管结石或胆泥。最常见的并发症是急性胆管炎（94.7%，36/38）。92.1%（35/38）的病例通过内镜方法成功取出支架。3例患者因支架取出失败，在原支架旁额外置入了一个塑料支架。73.7%（28/38）的病例内镜下成功取出胆管结石。根据支架置入时间（12至24个月和超过24个月）将患者分为两组，胆管炎的发生、胆石的存在以及内镜下结石和胆管支架取出的成功率均无差异。
长期留置塑料胆管支架最常见的并发症是与胆总管结石相关的急性胆管炎。大多数病例通过内镜处理成功。
