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经皮胆道支架取出术治疗胆肠吻合术后良性胆道狭窄。

Percutaneous biliary stent removal for benign biliary stricture post hepaticojejunostomy.

机构信息

Department of Medicine, Allama Iqbal Medical College, Lahore, Punjab, Pakistan.

Department of Radiology, The University of Alabama at Birmingham, Birmingham, Alabama, USA

出版信息

BMJ Case Rep. 2024 Apr 10;17(4):e259589. doi: 10.1136/bcr-2023-259589.

DOI:10.1136/bcr-2023-259589
PMID:38599795
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11015180/
Abstract

This case report presents the percutaneous extraction of a biliary stent in a patient with a history of liver transplant and Whipple procedure, suffering from benign biliary stricture post hepaticojejunostomy. After failed management with conventional benign biliary protocol, a fully covered WallFlex biliary stent was percutaneously placed and later removed using a balloon catheter technique. The procedure demonstrated anastomosis patency without complications, providing a drain-free option for complex anatomy where endoscopic management was not feasible. This case contributes valuable insights to the limited literature on percutaneous stent removal for benign biliary strictures, emphasising the importance of considering alternative approaches in challenging clinical scenarios.

摘要

本病例报告介绍了一位肝移植和胰十二指肠切除术病史的患者,因胆肠吻合术后良性胆管狭窄而接受经皮胆管支架取出术。在常规良性胆管处理方案失败后,我们采用完全覆膜的 WallFlex 胆管支架进行经皮治疗,随后使用球囊导管技术将其取出。该操作在无并发症的情况下显示出吻合口通畅,为内镜治疗不可行的复杂解剖结构提供了一种无引流的选择。本病例为有限的良性胆管狭窄经皮支架取出文献提供了有价值的见解,强调了在具有挑战性的临床情况下考虑替代方法的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1f9/11015180/95a640c1f65b/bcr-2023-259589f08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1f9/11015180/e85c5a932c30/bcr-2023-259589f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1f9/11015180/fb89a8bfe541/bcr-2023-259589f02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1f9/11015180/c7bfe2ea64dd/bcr-2023-259589f03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1f9/11015180/e1cf3b9e8878/bcr-2023-259589f04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1f9/11015180/2457b00cc283/bcr-2023-259589f05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1f9/11015180/8c3a68eca1da/bcr-2023-259589f06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1f9/11015180/9749b286bd83/bcr-2023-259589f07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1f9/11015180/95a640c1f65b/bcr-2023-259589f08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1f9/11015180/e85c5a932c30/bcr-2023-259589f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1f9/11015180/fb89a8bfe541/bcr-2023-259589f02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1f9/11015180/c7bfe2ea64dd/bcr-2023-259589f03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1f9/11015180/e1cf3b9e8878/bcr-2023-259589f04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1f9/11015180/2457b00cc283/bcr-2023-259589f05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1f9/11015180/8c3a68eca1da/bcr-2023-259589f06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1f9/11015180/9749b286bd83/bcr-2023-259589f07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1f9/11015180/95a640c1f65b/bcr-2023-259589f08.jpg

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本文引用的文献

1
Percutaneous Transhepatic Removal of Migrated Biliary Stent from a Chronic Biloma Cavity.经皮经肝从慢性胆汁瘤腔内取出移位的胆道支架
Taehan Yongsang Uihakhoe Chi. 2020 Mar;81(2):442-447. doi: 10.3348/jksr.2020.81.2.442. Epub 2020 Jan 30.
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Diagnosis and management of benign biliary strictures post liver transplantation in adults.成人肝移植术后良性胆管狭窄的诊断与管理
Transplant Rev (Orlando). 2021 Jan;35(1):100593. doi: 10.1016/j.trre.2020.100593. Epub 2020 Dec 25.
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Surgical relief of small bowel obstruction by migrated biliary stent: extraction without enterotomy.
通过移位胆管支架手术缓解小肠梗阻:无需肠切开术的取出术
JSLS. 2011 Apr-Jun;15(2):232-5. doi: 10.4293/108680811X13071180406998.
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Percutaneously placed covered retrievable stents for the treatment of biliary anastomotic strictures following living donor liver transplantation.经皮放置可回收覆盖支架治疗活体肝移植后胆肠吻合口狭窄。
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