在内镜超声导向肝胃肠切除术后,使用部分覆盖的支架与固定的支架进行重新干预的实用性
Il Sang Shin1, Jong Ho Moon2, Yun Nah Lee1
1Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon, Korea.
Digestive diseases and sciences
|January 27, 2025
概括
这项研究表明,一个新的部分覆盖的自扩展金属支架 (SEMS) 带有固定,可以在EUS-HGS后对复发性胆道阻塞进行安全有效的内镜再干预. 这种方法简化了需要重复手术的患者未来的治疗方法.
科学领域:
- 胃肠病学 胃肠病学
- 干预性内镜检查是干预性的内镜检查.
- 胆汁干预 胆汁干预
背景情况:
- 长自扩展金属支架 (SEMS) 用于内镜超声导向肝胃术 (EUS-HGS) 可能会阻碍复发性胆道阻塞 (RBO) 的重新干预.
- 需要一种新的支架设计,以便在EUS-HGS后进行内镜再干预.
研究的目的:
- 为了评估内镜再干预RBO的疗效和安全性,使用了一种具有固定的新型部分覆盖SEMS.
- 评估成功率,手术时间和与此新的支架设计相关的不良事件,以重新干预.
主要方法:
- 使用了一种部分覆盖的SEMS,其中有1.5厘米的肝内未覆盖部分和2.0厘米的 anchor flange.
- 通过in-situ支架光进行了重新干预.
- 主要结局包括技术和临床成功;次要结局包括手术时间,不良事件和RBO的时间.
主要成果:
- 在19名患者中进行了35次重复干预,成功率为97.1%的患者获得了支架亮度.
- 技术和临床成功率分别为94.3%和88.6%.
- 轻度胆管炎发生在5.7%的病例中,经过保守的管理. 在重新干预后,RBO的中位时间为148天.
结论:
- 内镜重新干预是可行的,并通过新型部分覆盖的SEMS与 anchoring边缘的光线安全.
- 这种支架设计简化了在EUS-HGS后复发性胆道阻塞的重新干预.
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