Ogura Takeshi, Nishioka Nobu, Yamada Masanori, Yamada Tadahiro, Ueno Saori, Matsuno Jyun, Ueshima Kazuya, Yamamoto Yoshitaro, Okuda Atsushi, Ashida Reiko, Higuchi Kazuhide
2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.
Departments of Cancer Survey and Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan.
Endosc Int Open. 2020 Jun;8(6):E733-E737. doi: 10.1055/a-1135-8804. Epub 2020 May 25.
A novel fine-gauge electrocautery dilator (ED) has recently become available in Japan. The current study evaluated the safety and feasibility of transluminal antegrade dilation for hepaticojejunal stricture (HJS) using this novel ED. Patients who with complicated HJS were retrospectively enrolled. The primary and secondary endpoints of this study were rates of technical success defined as functional antegrade HJS dilation using the novel ED and types of adverse events, respectively. A total of 22 patients were enrolled. Among them, six were treated using an enteroscopic approach due to the absence of bile duct dilation or patient refusal to undergo EUS-HGS. Therefore, 16 patients underwent EUS-HGS. The procedure was successful in 15 of 16 patients (93.8 %). The contrast medium flowed from the intrahepatic bile duct to the intestine of 14 of 15 patients (93.3 %). The resolution rate of HJS was 13 of 14 (92.9 %) at 6 months. Our technique might offer a new option with which to treat HJS, although a prospective study with long-term follow-up is needed.
一种新型细径电灼扩张器（ED）最近在日本上市。本研究评估了使用这种新型ED对肝空肠吻合口狭窄（HJS）进行腔内顺行扩张的安全性和可行性。对患有复杂HJS的患者进行了回顾性纳入。本研究的主要和次要终点分别是使用新型ED进行功能性顺行HJS扩张定义的技术成功率和不良事件类型。共纳入22例患者。其中，6例因无胆管扩张或患者拒绝接受内镜超声引导下肝胃吻合术（EUS-HGS）而采用肠镜检查方法治疗。因此，16例患者接受了EUS-HGS。16例患者中有15例（93.8%）手术成功。15例患者中有14例（93.3%）造影剂从肝内胆管流入肠道。6个月时，14例患者中有13例（92.9%）的HJS得到缓解。尽管需要进行长期随访的前瞻性研究，但我们的技术可能为治疗HJS提供一种新的选择。
