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内镜超声引导下胆囊引流:长期随访结果

Endoscopic ultrasound-guided gallbladder drainage: Results of long-term follow-up.

作者信息

Ahmed Omar, Ogura Takeshi, Eldahrouty Ali, Khalaf Hanaa, Mohammed Ehab, Okasha Hussein, Sameer Ayat, Abdelaal Usama, Higuchi Kazuhide

机构信息

Department of Internal Medicine, Osaka Medical College, Osaka, Japan; Department of Tropical Medicine, Minia University Hospital, Minia, Egypt.

Department of Internal Medicine, Osaka Medical College, Osaka, Japan.

出版信息

Saudi J Gastroenterol. 2018 May-Jun;24(3):183-188. doi: 10.4103/sjg.SJG_506_17.

Abstract

BACKGROUND/AIM: Recently, endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) has emerged using a self-expandable metallic stent (SEMS). The aim of the study was to evaluate the long-term outcomes of this procedure. In addition, the efficacy and safety of EUS-GBD with SEMS were assessed.

PATIENTS AND METHODS

Thirteen consecutive patients who underwent EUS-GBD for acute cholecystitis between February 2014 and September 2016 were included in this retrospective study. EUS-GBD was performed under the guidance of EUS and fluoroscopy, through puncturing the gallbladder with a needle, inserting a guidewire, dilating the puncture hole, and placing a SEMS.

RESULTS

The rates of technical success, functional success, and adverse events were 100%, 92.3% and 7.7%, respectively. The median procedure time was 26.9 min (range 19-42 min). The median follow-up time was 240 days (range 14-945 days) and during this follow-up period recurrence of cholecystitis was observed in one patient (7.7%).

CONCLUSION

EUS-GBD with a SEMS is a possible alternative treatment for acute cholecystitis in high surgical risk patients. Long-term outcomes after EUS-GBD were promising.

摘要

背景/目的:近年来,使用自膨式金属支架(SEMS)的内镜超声引导下胆囊引流术(EUS-GBD)已出现。本研究的目的是评估该手术的长期疗效。此外,还评估了EUS-GBD联合SEMS的有效性和安全性。

患者与方法

本回顾性研究纳入了2014年2月至2016年9月期间连续13例因急性胆囊炎接受EUS-GBD的患者。EUS-GBD在EUS和荧光透视引导下进行,通过用针穿刺胆囊、插入导丝、扩张穿刺孔并放置SEMS。

结果

技术成功率、功能成功率和不良事件发生率分别为100%、92.3%和7.7%。中位手术时间为26.9分钟(范围19 - 42分钟)。中位随访时间为240天(范围14 - 945天),在此随访期间,1例患者(7.7%)出现胆囊炎复发。

结论

EUS-GBD联合SEMS是高手术风险患者急性胆囊炎的一种可能替代治疗方法。EUS-GBD后的长期疗效良好。

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