Bureau Marc-Andre, Gkolfakis Paraskevas, Blero Daniel, Pezzullo Martina, Devière Jacques, Lemmers Arnaud
Université Libre de Bruxelles, Campus Erasme, Gastroenterology, Brussels, Belgium.
Université Libre de Bruxelles, Campus Erasme, Radiology, Brussels, Belgium.
Endosc Int Open. 2020 May;8(5):E573-E577. doi: 10.1055/a-1123-7782. Epub 2020 Apr 17.
Lateral duodenal wall perforation by a migrated stent is a potential complication of biliary stenting. By systematic database revision, we identified a series of six patients with lateral duodenal wall perforation caused by a displaced plastic biliary stent that were treated with over-the-scope clip (OTSC) between January 1, 2014 and March 31, 2019. In this series, most cases were related to stenting of benign strictures with single or double stenting and with the use of stents longer than 12 cm. OTSC permitted perforation closure in all cases. Most patients had an excellent outcome and did not need any subsequent intervention. However, one patient, who presented with a more severe pneumoretroperitoneum on computed tomography scan, required laparotomy with peritoneal lavage and eventually died due to this complication. We conclude that endoscopic treatment of these perforations with OTSC could be an effective alternative to surgery in selected patients.
移位支架导致十二指肠侧壁穿孔是胆道支架置入术的一种潜在并发症。通过系统的数据库检索，我们确定了一系列6例因塑料胆道支架移位导致十二指肠侧壁穿孔的患者，这些患者在2014年1月1日至2019年3月31日期间接受了经内镜圈套夹（OTSC）治疗。在该系列中，大多数病例与良性狭窄的单支架或双支架置入以及使用长度超过12厘米的支架有关。OTSC在所有病例中均实现了穿孔闭合。大多数患者预后良好，无需任何后续干预。然而，1例患者在计算机断层扫描上表现为更严重的腹膜后积气，需要进行剖腹探查和腹腔灌洗，最终因该并发症死亡。我们得出结论，对于部分患者，使用OTSC对这些穿孔进行内镜治疗可能是一种有效的手术替代方案。
