Temporary placement of covered self-expandable metallic stents in the management of benign biliary strictures.
Temporary placement of covered self-expandable metallic stents in the management of benign biliary strictures.
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临时放置覆膜自扩张金属支架治疗良性胆管狭窄。
DOI：
10.1111/j.1443-1661.2012.01273.x
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发表时间：
2012
期刊：
影响因子：
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通讯作者：
Moriwaki H.
中科院分区：
文献类型：
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作者：
Yasuda I;Mukai T;Doi S;Tomita E;Moriwaki H.
背景和目的：目前，内镜介入因其方便性和低发病率而被广泛尝试作为良性胆管狭窄的一线治疗。塑料管支架（PS）通常用于此类治疗;然而，覆膜自膨式金属支架（C-SEMS）在一些机构中越来越常用。临时放置C-SEMS可能会带来更好的结果，因为它们的直径更大，因此可以更好地扩张狭窄，特别是在难治性病例中。本研究的目的是评价C-SEMS的临时放置在良性胆管狭窄的管理的有效性。方法：我们回顾性地回顾了我们的内镜逆行胰胆管造影（ERCP）数据库（1996年5月至2010年12月），并提取了接受内镜治疗良性胆管狭窄的患者的数据。然后，对患者病历中的随访数据进行审查，以确定这些手术的长期结局。结果：所有患者（n= 56）最初均置入PS，伴或不伴球囊扩张。 然而，后来在12例患者中尝试了C-SEMS置入，因为狭窄难以置入PS。在随访期间，两名患者在15个月和17个月后死于不相关的疾病，另外两名患者在9个月和50个月后仍有C-SEMS。 在其余8例患者中，C-SEMS在中位放置6个月（范围，2-15）后取出。 该组中有7例患者在中位随访时间48个月时未发生复发。 然而，在一名患者中，狭窄复发后8个月的C-SEMS是removed.Conclusions：临时放置C-SEMS可以是一种治疗选择良性胆管狭窄，特别是在难治性病例。
Background and Aim:Currently, endoscopic intervention is widely attempted as the first‐line treatment of benign biliary strictures because of its convenience and low morbidity. Plastic tube stents (PS) are usually used for such treatment; however, covered self‐expandable metallic stents (C‐SEMS) are becoming more commonly used at some institutions. The temporary placement of C‐SEMS may lead to better outcomes because of their larger diameter and, therefore, better dilation of the stricture, especially in refractory cases. The aim of the present study was to evaluate the efficacy of the temporary placement of C‐SEMS in the management of benign biliary strictures.Methods:We retrospectively reviewed our endoscopic retrograde cholangiopancreatography (ERCP) database (May 1996 to December 2010), and extracted the data of patients who underwent endoscopic treatment for benign biliary strictures. Then, the follow‐up data from patient charts were reviewed to determine the long‐term outcomes of those procedures.Results:All patients (n= 56) initially had a PS placed, with or without balloon dilation. However, C‐SEMS placement was later attempted in 12 patients because the stricture was refractory to placement of the PS. During their follow‐up periods, two patients died of unrelated diseases after 15 and 17 months, and another two still had the C‐SEMS in place after 9 and 50 months. In the remaining eight patients, the C‐SEMS was removed after a median placement period of 6 months (range, 2–15). Seven patients in this group have not experienced a recurrence at a median follow‐up time of 48 months. However, in one patient, stenosis did recur 8 months after the C‐SEMS was removed.Conclusions:Temporary placement of C‐SEMS can be a treatment option for benign biliary strictures, especially in refractory cases.