Onteddu Nirmal Kumar Reddy, Mareddy Naga Sai Rasagna, Vulasala Sai Swarupa R, Onteddu Jayabharath, Virarkar Mayur
Department of Internal Medicine, University of Florida College of Medicine, Jacksonville, FL 32209, United States.
Department of Diagnostic Radiology, University of Alabama, Birmingham, AL 35294, United States.
World J Gastrointest Surg. 2024 Jul 27;16(7):2358-2361. doi: 10.4240/wjgs.v16.i7.2358.
Patients with malignant biliary obstruction, following endoscopic retrograde cholangiopancreatography (ERCP) failure could be referred for endoscopic-ultrasound-guided biliary drainage through electrocautery-enhanced (ECE) lumen-apposing metal stent (LAMS) placement. However, the efficacy and safety of ECE-LAMS in this scenario have remained debatable due to minimal scientific evidence. The current confirmed 91.0% clinical success, 96.7% technical success, 7.3% reintervention rate, and 17.5% adverse events, following the treatment of malignant biliary obstruction with ECE-LAMS delivery. Finally, ECE-LAMS proved to be a generalizable strategy for managing biliary obstruction for patients who were excluded from ERCP.
恶性胆管梗阻患者在内镜逆行胰胆管造影（ERCP）失败后，可转诊接受内镜超声引导下通过电灼增强（ECE）管腔贴附金属支架（LAMS）置入进行胆管引流。然而，由于科学证据极少，ECE-LAMS在这种情况下的疗效和安全性仍存在争议。目前证实，采用ECE-LAMS治疗恶性胆管梗阻后，临床成功率为91.0%，技术成功率为96.7%，再次干预率为7.3%，不良事件发生率为17.5%。最后，对于被排除在ERCP之外的患者，ECE-LAMS被证明是一种可推广的胆管梗阻管理策略。
