在ERCP后胆汁支架迁移引起的肠道穿孔:系统性审查
Natalie Wilson1, Chukwunonso Ezeani2, Abdellatif Ismail3
1Department of Internal Medicine, University of Minnesota Medical Center, Minneapolis, MN.
Journal of clinical gastroenterology
|July 15, 2024
概括
从迁移的内镜逆行性胆血管瘤学 (ERCP) 支架的肠道穿孔是一种罕见但严重的并发症. 大多数病例涉及44.5天内塑料胆道支架,显著死亡率为17.4%.
科学领域:
- 胃肠病学 胃肠病学
- 内镜检查是指内镜检查.
- 手术并发症 手术并发症
背景情况:
- 在ERCP后胆管支架的远端迁移可能会导致严重的并发症.
- 虽然大多数迁移的支架无问题通过,但肠道穿孔是一个报告的不良事件.
研究的目的:
- 系统地审查风险因素,临床特征和ERCP后的支架迁移导致的肠道穿孔的结果.
- 为了确定与这种并发症相关的患者和支架的特征.
主要方法:
- 在PubMed,EMBASE和Cochrane数据库中进行全面的文献搜索,截至2023年10月.
- 包括全长的英语文章报告肠道穿孔从支架迁移,不包括不完整或近端迁移.
- 遵守系统审查和元分析 (PRISMA) 准则的首选报告项目.
主要成果:
- 在92件物品中发现了132例肠道穿孔.
- 穿孔最常发生在小肠 (64.4%) 中,中位数为44.5天,通常涉及10 Fr塑料支架.
- 治疗包括手术 (52.3%) 或内镜 (42.4%),其中25.8%需要肠切除,总死亡率为17.4%.
结论:
- 在ERCP支架迁移后肠道穿孔是一个重要的风险,特别是在44.5天内使用塑料胆道支架时.
- 总体死亡率凸显了这种并发症的严重程度.
- 内镜医生必须对这种罕见但可能致命的不良事件保持警.
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