Radiofrequency ablation combined with multiple biliary metal stent placement using short‐type single‐balloon endoscope in patients with surgically altered anatomy
Radiofrequency ablation combined with multiple biliary metal stent placement using short‐type single‐balloon endoscope in patients with surgically altered anatomy
复制标题
使用短型单球囊内窥镜射频消融联合多个胆道金属支架植入术治疗手术改变解剖结构的患者
DOI：
10.1111/den.13016
复制
发表时间：
2018
影响因子：
5.3
通讯作者：
M. Yoneda
中科院分区：
文献类型：
--
作者：
Tadahisa Inoue;Kiyoaki Ito;M. Yoneda
放置多个金属支架（MS）用于治疗高度恶性肝门胆道梗阻（MHBO）是有用的，胆道射频消融（RFA）已被建议改善支架通畅。然而，据我们所知，在手术改变解剖结构的患者中，没有使用单球囊内窥镜（SBE）进行RFA手术的报道。在这里，我们报告了一例RFA联合SBE在Roux-en-Y胃切除术中放置多MS的成功病例。一名70多岁的男性，有远端胃切除术和Roux-en-Y重建的历史，由于不可切除的铋IV型MHBO而出现黄疸。胆道支架置入时，将一个短型SBE （SIF-H290S; Olympus Medical Systems, Tokyo, Japan）插入十二指肠乳头。在胆道插管和导丝穿过狭窄后，使用Habib EndoHPB （EMcision, London， UK；图1）进行射频消融，输出功率为7 W，消融时间为1.5 min。3个MS （5.7Fr递送系统，BileRush Selective; Piolax Medical Devices，神奈川，日本），使用局部放置
PLACEMENT OF MULTIPLE metal stents (MS) for the management of high-grade malignant hilar biliary obstruction (MHBO) is useful, and biliary radiofrequency ablation (RFA) has been suggested to improve stent patency. However, to our knowledge, there are no reports of RFA procedures carried out using a single-balloon endoscope (SBE) in patients with surgically altered anatomy. Here, we report a successful case of RFA combined with multiple MS placement using SBE in Roux-en-Y gastrectomy. A man in his 70s, with a history of distal gastrectomy with Roux-en-Y reconstruction, developed jaundice as a result of unresectable Bismuth type IV MHBO. For biliary stenting, a short-type SBE (SIF-H290S; Olympus Medical Systems, Tokyo, Japan) was inserted into the duodenal papilla. Following biliary cannulation and guidewire insertion across the stricture, RFA was carried out using Habib EndoHPB (EMcision, London, UK; Fig. 1) at an output power of 7 W with a 1.5-min ablation time. Three MS (5.7Fr delivery system, BileRush Selective; Piolax Medical Devices, Kanagawa, Japan), were placed using the partial