Kuraoka Naosuke, Ujihara Tetsuro, Kasahara Hiromi, Suzuki Yuto, Sakai Shun, Hashimoto Satoru
Department of Gastroenterology, Saiseikai Kawaguchi General Hospital, Kawaguchi, Japan.
Department of Gastroenterology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan.
Clin Endosc. 2023 Nov;56(6):795-801. doi: 10.5946/ce.2022.289. Epub 2023 Apr 11.
BACKGROUND/AIMS: Endoscopic biliary drainage is the gold standard treatment for cholangitis. The two methods of biliary drainage are endoscopic biliary stenting and nasobiliary drainage. A novel integrated outside biliary stent and nasobiliary drainage catheter system (UMIDAS NB stent; Olympus Medical Systems) was recently developed. In this study, we evaluated the efficacy of this stent in the treatment of cholangitis caused by common bile duct stones or distal bile duct strictures.
We conducted a retrospective pilot study by examining the medical records of patients who required endoscopic biliary drainage for cholangitis due to common bile duct stones or distal bile duct strictures, and who were treated with a UMIDAS NB stent, between December 2021 and July 2022.
Records of 54 consecutive patients were reviewed. Technical and clinical success rates were 47/54 (87.0%) and 52/54 (96.3%), respectively. Adverse events were observed in 12 patients, with six patients experiencing pancreatitis as an adverse event, following endoscopic retrograde cholangiopancreatography (ERCP). Regarding late adverse events, five cases of biliary stent migration into the bile duct were observed. Disease-related death occurred in one patient.
The outside-type UMIDAS NB stent is an efficacious new method for biliary drainage and can be applied to many indications.
背景/目的:内镜下胆道引流是胆管炎的金标准治疗方法。胆道引流的两种方法是内镜下胆道支架置入术和鼻胆管引流术。一种新型的集成式体外胆道支架和鼻胆管引流导管系统(UMIDAS NB支架;奥林巴斯医疗系统公司)最近被研发出来。在本研究中,我们评估了该支架在治疗由胆总管结石或远端胆管狭窄引起的胆管炎方面的疗效。
我们通过查阅2021年12月至2022年7月期间因胆总管结石或远端胆管狭窄导致胆管炎而需要进行内镜下胆道引流且接受UMIDAS NB支架治疗的患者的病历,进行了一项回顾性试点研究。
回顾了54例连续患者的记录。技术成功率和临床成功率分别为47/54(87.0%)和52/54(96.3%)。12例患者出现不良事件,其中6例患者在内镜逆行胰胆管造影术(ERCP)后发生胰腺炎这一不良事件。关于晚期不良事件,观察到5例胆道支架移入胆管的情况。1例患者发生与疾病相关的死亡。
体外型UMIDAS NB支架是一种有效的胆道引流新方法,可应用于多种适应证。