Department of Gastroenterology, Ankara City Hospital.
Department of Gastroenterology, Memorial Kayseri Hospital, Kayseri.
Surg Laparosc Endosc Percutan Tech. 2021 Jun 23;31(6):697-702. doi: 10.1097/SLE.0000000000000966.
The aim of this study was to investigate the incidence, risk factors, and treatment strategies of proximally migrated pancreatic stents.
The data of 626 sessions of 421 patients with pancreatic duct stenting were retrospectively analyzed between 2010 and 2018, and patients with proximally migrated stents were included in the study.
Of 626 stents examined, 77 migrated proximally (12%). The migration rate (MR) was 16%, 2%, and 7%, respectively, in patients treated with chronic pancreatitis, malignancy, and pancreatic leakage indication. The MR was 14% in procedures with pancreatic duct stenosis, 21% in procedures with pancreatic sphincterotomy, and 27% in procedures performed from minor papillae. The MR of the 5, 7, and 10 Fr stents was 4%, 17%, and 10%, respectively. Of the 77 migrated stents, 64 were successfully removed (83%). This success rate (SR) was 84% in procedures with chronic pancreatitis indication, 83% in procedures with pancreatic duct stenosis, 79% in procedures with sphincterotomy, and 75% in procedures performed from minor papillae. The SR of the 5, 7, and 10 Fr stents was 100%, 79%, and 92%, respectively. It was also determined that 33 stents were fractured and migrated (43%). The SR of the fractured stents was 76%. Moreover, of the stents that were successfully removed, 35 were removed with forceps (55%) and 15 (23%) were removed with a balloon. Furthermore, in 47 cases, the stent was removed in the first session (73%). Acute pancreatitis occurred in 5 patients (8%) and perforation occurred in 1 patient (2%).
In this study, it was shown that proximal migration of pancreatic stents is frequent and most of these stents can be removed successfully.
本研究旨在探讨近端移位胰管支架的发生率、危险因素和治疗策略。
回顾性分析 2010 年至 2018 年间 421 例患者 626 次胰管支架置入术的数据，纳入近端移位支架的患者。
626 个支架中，77 个支架近端迁移（12%）。慢性胰腺炎、恶性肿瘤和胰漏治疗组的迁移率（MR）分别为 16%、2%和 7%。胰管狭窄组 MR 为 14%，胰管括约肌切开术组为 21%，从小乳头进行的手术组为 27%。5、7 和 10Fr 支架的 MR 分别为 4%、17%和 10%。77 个迁移的支架中，64 个（83%）成功取出。慢性胰腺炎治疗组的成功率（SR）为 84%，胰管狭窄组为 83%，括约肌切开术组为 79%，从小乳头进行的手术组为 75%。5、7 和 10Fr 支架的 SR 分别为 100%、79%和 92%。还发现 33 个支架断裂和迁移（43%）。断裂支架的 SR 为 76%。此外，在成功取出的支架中，35 个（55%）用夹钳取出，15 个（23%）用球囊取出。此外，47 例患者在第一时间取出支架（73%）。5 例（8%）患者发生急性胰腺炎，1 例（2%）患者发生穿孔。
本研究表明，胰管支架近端迁移较为常见，大多数支架可成功取出。
