Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, South Korea.
Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, South Korea.
Clin Radiol. 2020 Nov;75(11):879.e1-879.e6. doi: 10.1016/j.crad.2020.06.029. Epub 2020 Jul 26.
To evaluate the technical feasibility and safety of percutaneous recanalisation of benign postoperative hepaticojejunostomy strictures using the reverse end of a microwire.
Twenty-one patients with benign postoperative hepaticojejunostomy strictures that had failed to recanalise following management with conventional percutaneous techniques from January 2012 to March 2019 were included in the study. The stricture was punctured by the reverse end of a microwire. Subsequently, serial balloon dilatation and covered stent placement was performed. Technical as well as clinical success, complications, and patency of the hepaticojejunostomy were evaluated.
Technical success was achieved in 19 of 21 (90.5%) patients. The mean number of treatment sessions was 1.2 (range, 1-2). The obstructive symptoms were resolved within 3 days after the procedure in 19 patients (100%). There were no major complications. The 1-year and 3-year patency rates were 76.9% and 61.5%, respectively.
Percutaneous recanalisation using the reverse end of a microwire is technically feasible and safe in the treatment of benign postoperative hepaticojejunostomy strictures. This technique is useful when the conventional percutaneous technique cannot be used to cross the stricture.
评估使用微导丝反端经皮治疗良性术后胆肠吻合口狭窄的技术可行性和安全性。
本研究纳入了 2012 年 1 月至 2019 年 3 月期间因常规经皮技术治疗失败的 21 例良性术后胆肠吻合口狭窄患者。采用微导丝反端穿刺狭窄部位。随后进行系列球囊扩张和覆膜支架置入。评估技术及临床成功率、并发症及胆肠吻合口通畅情况。
21 例患者中，19 例（90.5%）获得技术成功。平均治疗次数为 1.2 次（范围，1-2 次）。19 例（100%）患者的梗阻症状在术后 3 天内得到缓解。无重大并发症发生。1 年和 3 年的通畅率分别为 76.9%和 61.5%。
使用微导丝反端经皮治疗良性术后胆肠吻合口狭窄是一种技术上可行且安全的方法。当常规经皮技术无法通过狭窄部位时，该技术很有用。
