Stavrou George, Rafailidis Vasileios, Diamantidou Anna, Kouskouras Constantinos, Michalopoulos Antonios, Kotzampassi Katerina
Department of Surgery, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece.
Department of Radiology, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece.
Asian J Endosc Surg. 2019 Jul;12(3):326-328. doi: 10.1111/ases.12642. Epub 2018 Aug 23.
Laparotomy and reoperation remain the standard procedures for patients with suture line disruption after the initial surgical treatment for duodenal ulcer perforation has failed. Recently, endoscopic stents have been employed for dehiscence of the suture line after a surgical repair or even as a primary treatment. We present such a case, the fourth in the literature. In this case, a partially covered stent was placed to cover the duodenal perforation opening after an unsuccessful stitching 6 days earlier. We discuss the difficulties in stent positioning, the choice of sealant, and possible complications. Overall, for older patients with comorbidities, endoscopic stent placement could be considered a promising alternative minimally invasive treatment.
对于十二指肠溃疡穿孔初次手术治疗失败后出现缝线裂开的患者，剖腹手术和再次手术仍是标准治疗方法。近来，内镜支架已被用于手术修复后缝线裂开的情况，甚至作为初始治疗手段。我们报告了这样一例病例，这是文献中的第四例。在此病例中，在6天前缝合失败后，放置了一个部分覆盖的支架以覆盖十二指肠穿孔开口。我们讨论了支架定位的困难、密封剂的选择以及可能的并发症。总体而言，对于有合并症的老年患者，内镜支架置入可被视为一种有前景的微创替代治疗方法。
