Self-expanding metal stents in benign biliary strictures due to chronic pancreatitis
Self-expanding metal stents in benign biliary strictures due to chronic pancreatitis
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DOI：
10.1055/s-2004-814319
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发表时间：
2004-05-01
期刊：
影响因子：
9.3
通讯作者：
Bruno, MJ
中科院分区：
文献类型：
--
作者：
van Berkel, AM;Cahen, DL;Bruno, MJ
背景和研究目的：在选定的慢性胰腺炎患者中，传统的塑料支架失败，在手术禁忌或下降，插入胆道自膨式金属支架（SEMS）可能是一个有价值的治疗选项。患者和方法：1994年和1999年之间，13例慢性胰腺炎患者接受SEMS良性胆管狭窄（4名女性和9名男性，平均年龄56岁）。SEMS放置的适应症为：手术禁忌症（n = 10）、假定不可手术的胰腺癌（n = 1）、合并不可切除的肺癌（n = 1）和拒绝手术（n = 1）。成功的治疗被定义为充分的胆道引流由于SEMS therapy.Results：平均随访时间为50个月（范围6天至86个月）。9例患者（69%）成功接受了SEMS治疗：第一个SEMS通畅（n = 5）;第二个SEMS通过第一个SEMS插入通畅（n = 3）; 1例SEMS在球囊清洁后通畅。4例患者的SEMS治疗未成功（1例因支架移位，3例因闭塞）。SEMS的平均通畅期为60个月（95% CI，43个月- 77个月）。在33个月时，SEMS治疗充分胆道引流的可能性为75%。结论：SEMS治疗是安全的，并在一组选定的慢性胰腺炎所致良性胆道狭窄患者中提供了成功和延长的胆道引流，这些患者不可能或不需要手术干预。
Background and Study Aims: In selected patients with chronic pancreatitis in whom conventional plastic stenting fails and in whom surgery is contraindicated or declined, insertion of a biliary self-expanding metal stent (SEMS) may be a valuable treatment option.Patients and Methods: Between 1994 and 1999, 13 patients with chronic pancreatitis received SEMS for benign biliary strictures (four women and nine men; mean age 56). The indications for SEMS placement were: contraindication to surgery (n = 10), presumed inoperable pancreatic carcinoma (n = 1), concomitant unresectable lung cancer (n = 1), and declined surgery (n = 1). The success of treatment was defined as adequate biliary drainage due to SEMS therapy.Results: The mean follow-up period was 50 months (range 6 days - 86 months). Nine patients (69%) were successfully treated with SEMS therapy: a patent first SEMS (n = 5); a patent second SEMS inserted through the first SEMS (n = 3); and one patent SEMS after balloon cleaning. SEMS treatment was not successful in four patients (due to stent migration in one case and occlusion in three). The mean patency period of the SEMS was 60 months (95% Cl, 43 months - 77 months). At 33 months, the probability of adequate biliary drainage with SEMS therapy was 75%.Conclusions: SEMS therapy was safe and provided successful and prolonged biliary drainage in a selected group of patients with benign biliary strictures due to chronic pancreatitis in whom surgical intervention was not possible or desirable.