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经皮经肝胆囊引流术后内镜下胆囊支架置入的益处。

Benefits of endoscopic gallbladder stenting following percutaneous transhepatic gallbladder drainage.

作者信息

Niiya Fumitaka, Tamai Naoki, Yamawaki Masataka, Noda Jun, Azami Tetsushi, Takano Yuichi, Nishimoto Fumiya, Nagahama Masatsugu

机构信息

Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama 227-8501, Kanagawa, Japan.

出版信息

World J Gastrointest Surg. 2024 Sep 27;16(9):2902-2909. doi: 10.4240/wjgs.v16.i9.2902.

Abstract

BACKGROUND

Endoscopic transpapillary gallbladder drainage is challenging because of the complexity of the procedure and high incidence of adverse events (AEs). To overcome these problems, endoscopic gallbladder stenting (EGBS) after percutaneous transhepatic gallbladder drainage (PTGBD) can be effective, as it mitigates inflammation and adhesion.

AIM

To examine the benefits of EGBS after PTGBD to assess its efficacy and impact on AEs.

METHODS

We retrospectively analyzed data from 35 patients who underwent EGBS after PTGBD at a single center between January 2016 and December 2023. The primary outcomes were technical success and AEs, and the rate of recurrent cholecystitis was evaluated. In addition, the reasons for the failure of the procedure were identified.

RESULTS

Among the 35 patients, the technical success rate was 77.1% and the final contrast of the cystic duct was successful in 97.1% of patients. The incidence of early AEs was relatively low (11.4%), with no instances of cystic duct perforation. The rate of recurrent cholecystitis was 3.7%, and no other biliary events were observed.

CONCLUSION

EGBS after PTGBD may be significantly beneficial, with a substantial success rate and minimal AEs in both short- and long-term follow-ups.

摘要

背景

由于操作复杂且不良事件(AE)发生率高,内镜经乳头胆囊引流具有挑战性。为克服这些问题,经皮经肝胆囊引流(PTGBD)后进行内镜胆囊支架置入术(EGBS)可能有效,因为它可减轻炎症和粘连。

目的

研究PTGBD后EGBS的益处,以评估其疗效及对AE的影响。

方法

我们回顾性分析了2016年1月至2023年12月在单一中心接受PTGBD后EGBS的35例患者的数据。主要结局为技术成功率和AE,并评估复发性胆囊炎的发生率。此外,确定手术失败的原因。

结果

35例患者中,技术成功率为77.1%,97.1%的患者胆囊管最终造影成功。早期AE的发生率相对较低(11.4%),无胆囊管穿孔病例。复发性胆囊炎的发生率为3.7%,未观察到其他胆道事件。

结论

PTGBD后EGBS可能具有显著益处,在短期和长期随访中成功率高且AE极少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/771a/11438794/c9d7245cdd1d/WJGS-16-2902-g001.jpg

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