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生理性胰腺支架治疗慢性胰腺炎的影响。

Impact of physiologically shaped pancreatic stent for chronic pancreatitis.

机构信息

Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.

Department of Community-Based Medical Education, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.

出版信息

Sci Rep. 2021 Apr 15;11(1):8285. doi: 10.1038/s41598-021-87852-1.

Abstract

Endoscopic pancreatic stenting is used to prevent main pancreatic duct obstruction and relieve painful symptoms of chronic pancreatitis. However, the stent typically needs to be exchanged and the rate of adverse events is high. Few studies have evaluated the effect of stent shape on those outcomes. We evaluated the adverse events, stent patency, and total medical cost within 90 days of patients who received an 8.5 French (Fr) physiologically shaped pancreatic stent by comparing these features with those associated with a conventional straight-type stent for ≥ 90 days. The total stent-related adverse event rate was significantly lower for the physiologically shaped pancreatic stent (physiologically shaped, 6.7% [2/30]; straight-type, 50.6% [44/87]; P < 0.001). Stent occlusion was significantly less frequent (P < 0.001) and the total medical costs were significantly lower (P = 0.002) for the physiologically shaped stent. The stent-related adverse event rate was significantly higher for the 10 Fr straight type stent than for the 8.5 Fr physiologically shaped stent (10 Fr, straight-type vs. 8.5 Fr, physiologically shaped: 36.1% [13/36] vs. 6.7% [2/30]; P = 0.007). In conclusion, a physiologically shaped pancreatic stent was superior to a straight-type stent in terms of the patency rate and medical costs.

摘要

内镜下胰腺支架置入术用于预防主胰管阻塞和缓解慢性胰腺炎的疼痛症状。然而,支架通常需要更换,且不良事件发生率较高。很少有研究评估支架形状对这些结果的影响。我们通过比较 8.5Fr 生理性胰腺支架与传统直型支架≥90 天的不良事件、支架通畅率和 90 天内总医疗费用,评估了接受 8.5Fr 生理性胰腺支架的患者的不良事件、支架通畅率和 90 天内总医疗费用。生理性胰腺支架的总支架相关不良事件发生率明显低于直型支架(生理性,6.7%[2/30];直型,50.6%[44/87];P<0.001)。支架闭塞明显较少(P<0.001),且生理性支架的总医疗费用明显较低(P=0.002)。10Fr 直型支架的支架相关不良事件发生率明显高于 8.5Fr 生理性支架(10Fr 直型 vs. 8.5Fr 生理性:36.1%[13/36] vs. 6.7%[2/30];P=0.007)。总之,生理性胰腺支架在通畅率和医疗费用方面优于直型支架。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d587/8050315/1f1aa8e5811d/41598_2021_87852_Fig1_HTML.jpg

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