From the Department of Gastroenterology, First Affiliated Hospital of Naval Medical University.
Pancreas. 2024 Sep 1;53(8):e694-e699. doi: 10.1097/MPA.0000000000002354. Epub 2024 May 1.
Proximal migration is one of the complications after pancreatic duct stenting. This study aimed to determine the incidence of proximal migration and to analyze the rescue methods.
A search was performed in MEDLINE/Embase database. The literatures included were reviewed and analyzed. Retrieval tools were classified into the following 3 classes: class A works by indirectly contacting the outer surface of the stent. Class B works by directly contacting the outer surface. Class C works by directly contacting the inner surface.
416 literatures were retrieved from 1983 to 2021. 15 literatures were included. The incidence of proximal migration of pancreatic stents was 4.7% (106/2246). The success rate of endotherapy was 86.6% (214/247), and the surgical conversion rate of it was 9.3%. Among the 214 cases in which the displaced stents were successfully removed under endoscopy, 49 cases (22.9%) used class A methods, 154 cases (72.0%) used class B methods, and 11 cases (5.1%) used class C methods. The overall rate of postoperative complication was 12.1%, including postprocedure pancreatitis (9.1%, 18/247), followed by bleeding (1.5%), perforation (1.0%), and biliary infection (0.5%).
Endoscopy is an effective method for the treatment of proximal displacement of pancreatic stents with acceptable complication rate.
胰管支架置入后近端迁移是其并发症之一。本研究旨在确定近端迁移的发生率，并分析其解救方法。
在 MEDLINE/Embase 数据库中进行了检索。对检索到的文献进行了回顾和分析。检索工具分为以下 3 类：A 类通过间接接触支架的外表面起作用。B 类通过直接接触支架的外表面起作用。C 类通过直接接触支架的内表面起作用。
从 1983 年至 2021 年共检索到 416 篇文献，纳入 15 篇文献。胰管支架近端迁移的发生率为 4.7%（106/2246）。内镜治疗的成功率为 86.6%（214/247），手术转化率为 9.3%。在 214 例经内镜成功取出移位支架的患者中，49 例（22.9%）采用 A 类方法，154 例（72.0%）采用 B 类方法，11 例（5.1%）采用 C 类方法。术后并发症总发生率为 12.1%，包括术后胰腺炎（9.1%，18/247），其次是出血（1.5%）、穿孔（1.0%）和胆道感染（0.5%）。
对于胰管支架近端移位，内镜治疗是一种有效的方法，其并发症发生率可接受。
