Uchida Daisuke, Kawamoto Hirofumi, Kato Hironari, Goto Daisuke, Tomoda Takeshi, Matsumoto Kazuyuki, Yamamoto Naoki, Horiguchi Shigeru, Tsutsumi Koichiro, Okada Hiroyuki
Department of Gastroenterology, Okayama University Hospital, Okayama, Japan.
Department of General Internal Medicine 2, Kawasaki Hospital, Kawasaki Medical School, 2-6-1 Nakasange, Kita-ku, Okayama, Japan.
J Med Ultrason (2001). 2018 Jul;45(3):399-403. doi: 10.1007/s10396-017-0846-x. Epub 2017 Dec 13.
Although EUS-guided hepaticogastrostomy (EUS-HGS) with a covered self-expandable metal stent (SEMS) is a useful procedure, it is associated with severe adverse events, including stent migration. We, therefore, developed an intra-conduit release method, and investigated whether the technique yields a safer and more stable procedure.
The intra-conduit release method is a procedure to release the SEMS in the working channel conduit of the scope for anchoring between the liver and stomach to avoid stent migration. Forty-three patients who underwent EUS-HGS at two high-volume centers in Japan were enrolled in this retrospective study, and the safety and usefulness of this method were evaluated retrospectively.
The intra-conduit release method was applied in 36 cases. The technical success rate of EUS-HGS with the intra-conduit release method was significantly higher in comparison with the conventional method. Additionally, the rate of early adverse events was significantly lower than that for the conventional method.
The intra-conduit release method during EUS-HGS is useful for a stable procedure that avoids early adverse events.
尽管使用覆膜自膨式金属支架（SEMS）的超声内镜引导下肝胃吻合术（EUS-HGS）是一种有用的手术方法，但它与包括支架移位在内的严重不良事件相关。因此，我们开发了一种导管内释放方法，并研究该技术是否能产生更安全、更稳定的手术效果。
导管内释放方法是一种在超声内镜工作通道导管内释放SEMS，使其锚定在肝脏和胃之间以避免支架移位的手术方法。在日本两家大型中心接受EUS-HGS的43例患者纳入了这项回顾性研究，并对该方法的安全性和实用性进行了回顾性评估。
36例应用了导管内释放方法。与传统方法相比，采用导管内释放方法的EUS-HGS技术成功率显著更高。此外，早期不良事件发生率显著低于传统方法。
EUS-HGS期间的导管内释放方法有助于实现稳定的手术过程并避免早期不良事件。
