Efficacy of a novel ultra-sharp dilation device for dilating bare metal stent mesh in patients with hilar malignant biliary obstruction
Efficacy of a novel ultra-sharp dilation device for dilating bare metal stent mesh in patients with hilar malignant biliary obstruction
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新型超锐扩张器扩张裸金属支架网对肝门部恶性胆道梗阻患者的疗效
DOI：
10.1080/00365521.2021.1879243
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发表时间：
2021
影响因子：
1.9
通讯作者：
Sakamoto Naoya
中科院分区：
文献类型：
--
作者：
Kato Shin;Kuwatani Masaki;Kawakubo Kazumichi;Furukawa Ryutaro;Hirata Koji;Takishin Yunosuke;Hirata Hajime;Sakamoto Naoya
当已经存在金属支架时，在肝门部恶性胆道梗阻患者中放置额外的支架可能具有挑战性，因为有时额外支架的导管和输送系统无法穿过先前放置的支架的网。我们连续研究了 10 例使用新型超锐扩张器（ES 扩张器）接受网状扩张的肝门部恶性胆道梗阻患者，以评估 ES 扩张器用于网状扩张的有效性和安全性。使用 ES 扩张器的网状扩张在 8 名患者中获得成功（8/10；80.0%），与使用 Soehendra 胆管扩张导管预扩张的患者（4/5，80.0%）和未预扩张的患者（4/5，80.0%）的成功率相同。在两名扩张失败的患者中，肝门部胆管分支的角度太陡，无法让坚硬的扩张装置通过。尽管如此，所有网状扩张患者的支架置入并不复杂（8/8，100.0%），并且没有观察到与 ES 扩张器相关的不良事件。超锋利扩张装置对于金属支架网扩张的功效似乎很有希望，特别是对于传统方法不成功的患者。然而，需要更多数据来证实我们的发现。
The placement of additional stents in patients with hilar malignant biliary obstruction can be challenging when a metal stent already exists because occasionally, the catheter and delivery system of the additional stent cannot pass through the mesh of the formerly placed stent. We studied ten consecutive patients with hilar malignant biliary obstruction who underwent mesh dilation using a novel ultra-sharp dilation device (ES dilator) to assess the efficacy and safety of the ES dilator for mesh dilation. Mesh dilation using the ES dilator was successful in eight patients (8/10; 80.0%), which was the same rate as that of patients with pre-dilation using a Soehendra biliary dilation catheter (4/5, 80.0%) and patients without pre-dilation (4/5, 80.0%). In the two patients with dilation failure, the angle of the hilar bile duct branch was too steep to permit the passage of a stiff dilation device. Nonetheless, stent placement was uncomplicated in all mesh-dilated patients (8/8, 100.0%), and no adverse events related to the ES dilator were observed. The efficacy of an ultra-sharp dilation device appears promising for metallic stent mesh dilation, especially in patients where conventional methods are unsuccessful. However, additional data are necessary to confirm our findings.
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影响因子：
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