鸭嘴型抗反流自膨式金属支架用于伴有十二指肠侵犯的远端恶性胆管梗阻的有效性：一项初步研究。
Usefulness of duckbill-type anti-reflux self-expandable metal stents for distal malignant biliary obstruction with duodenal invasion: A pilot study.
作者信息
Kobori Ikuhiro, Katayama Yasumi, Hayakawa Fuki, Fujiwara Takeshi, Kuwada Masaru, Gyotoku Yoshinori, Kitahama Akihiro, Kusano Yumi, Tamano Masaya
机构信息
Department of Gastroenterology Dokkyo Medical University Saitama Medical Center Saitama Japan.
Endoscopy Center, Dokkyo Medical University Saitama Medical Center Saitama Japan.
出版信息
DEN Open. 2022 Mar 9;2(1):e103. doi: 10.1002/deo2.103. eCollection 2022 Apr.
OBJECTIVES
Early obstruction of a self-expandable metal stent placed for distal malignant biliary obstruction is more likely to occur in the presence of duodenal invasion. An anti-reflux self-expandable metal stent (ARMS) has been developed for the purpose of preventing duodenal fluid reflux into the bile duct. In this study, we evaluated the usefulness and safety of a duckbill-type ARMS (D-ARMS) in the situation of duodenal invasion.
METHODS
We retrospectively analyzed 10 consecutive patients who received D-ARMS for distal malignant biliary obstruction with duodenal invasion. We evaluated non-occlusion cholangitis, recurrent biliary obstruction (RBO), and adverse events after D-ARMS placement.
RESULTS
There were no cases of non-occlusion cholangitis. RBO was observed in 2 patients (20%), and time to RBO was 236 days and 117 days, respectively. The causes of RBO were overgrowth and sludge formation. The median time to RBO was 382 days (range, 117-382 days). Only one adverse event was observed (cholecystitis).
CONCLUSIONS
D-ARMS shows potential as an optimal ARMS.
目的
对于因远端恶性胆管梗阻而置入的自膨式金属支架，十二指肠受侵时更易发生早期梗阻。为防止十二指肠液反流至胆管，已研发出一种抗反流自膨式金属支架（ARMS）。在本研究中，我们评估了鸭嘴型ARMS（D-ARMS）在十二指肠受侵情况下的有效性和安全性。
方法
我们回顾性分析了10例因远端恶性胆管梗阻伴十二指肠受侵而接受D-ARMS治疗的连续患者。我们评估了D-ARMS置入后的非闭塞性胆管炎、复发性胆管梗阻（RBO）及不良事件。
结果
无非闭塞性胆管炎病例。2例患者（20%）出现RBO，RBO发生时间分别为236天和117天。RBO的原因是过度生长和胆泥形成。RBO的中位时间为382天（范围117 - 382天）。仅观察到1例不良事件（胆囊炎）。
结论
D-ARMS显示出作为一种理想ARMS的潜力。
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