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内镜超声引导下胆囊引流永久性支架置入的临床结果

Clinical outcomes of permanent stenting with endoscopic ultrasound gallbladder drainage.

作者信息

Suzuki Eisuke, Fujita Yuji, Hosono Kunihiro, Koyama Yuji, Tsujino Seitaro, Teratani Takuma, Nakajima Atsushi, Matsuhashi Nobuyuki

机构信息

Department of Hepato-Biliary-Pancreatic Medicine, NTT Tokyo Medical Center, Tokyo, Japan.

Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan.

出版信息

Clin Endosc. 2023 Sep;56(5):650-657. doi: 10.5946/ce.2022.190. Epub 2023 Apr 5.

Abstract

BACKGROUND/AIMS: Endoscopic ultrasound gallbladder drainage (EUS-GBD) is gaining attention as a treatment method for cholecystitis. However, only a few studies have assessed the outcomes of permanent stenting with EUS-GBD. Therefore, we evaluated the clinical outcomes of permanent stenting using EUS-GBD.

METHODS

This was a retrospective, single-center cohort study. The criteria for EUS-GBD at our institution are a high risk for surgery, inability to perform surgery owing to poor performance status, and inability to obtain consent for emergency surgery. EUS-GBD was performed using a 7-Fr double-pigtail plastic stent with a dilating device. The primary outcomes were the recurrence-free rate of cholecystitis and the late-stage complication-avoidance rate. Secondary outcomes were technical success, clinical success, and procedural adverse events.

RESULTS

A total of 41 patients were included in the analysis. The median follow-up period was 168 (range, 10-1,238) days. The recurrence-free and late-stage complication-avoidance rates during the follow-up period were 95% (38 cases) and 90% (36 cases), respectively. There were only two cases of cholecystitis recurrence during the study period.

CONCLUSION

EUS-GBD using double-pigtail plastic stent was safe and effective with few complications, even in the long term, in patients with acute cholecystitis.

摘要

背景/目的:内镜超声引导下胆囊引流术(EUS-GBD)作为胆囊炎的一种治疗方法正受到关注。然而,仅有少数研究评估了EUS-GBD置入永久性支架的疗效。因此,我们评估了使用EUS-GBD置入永久性支架的临床疗效。

方法

这是一项回顾性单中心队列研究。我们机构进行EUS-GBD的标准为手术高风险、因身体状况差无法进行手术以及无法获得急诊手术同意。使用带扩张装置的7Fr双猪尾塑料支架进行EUS-GBD。主要结局为胆囊炎无复发率和晚期并发症避免率。次要结局为技术成功率、临床成功率和手术不良事件。

结果

共有41例患者纳入分析。中位随访期为168(范围10 - 1238)天。随访期间无复发率和晚期并发症避免率分别为95%(38例)和90%(36例)。研究期间仅2例胆囊炎复发。

结论

对于急性胆囊炎患者,使用双猪尾塑料支架的EUS-GBD即使在长期也是安全有效的,并发症较少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6380/10565443/6d7d85a1b5e8/ce-2022-190f1.jpg

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