在非恶性胆道狭窄的情况下,完全覆盖的金属支架的去除失败:风险因素和解决技术
Nicolò de Pretis1, Lorenzo Santaera1, Luigi Martinelli2
1Medicine, University of Verona, Verona, Italy.
FC-SEMS-in-FC-SEMS技术是一种安全有效的方法,用于移除完全覆盖的自扩展金属支架 (FC-SEMS),但无法移除. 减少支架停留时间,特别是在以前有胆管支架的患者中,可以最大限度地减少FC-SEMS去除失败.
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:
- 完全覆盖的自扩展金属支架 (FC-SEMS) 是非恶性胆道狭窄的标准.
- 由于高塑性组织而导致的去除失败是FC-SEMS的已知并发症.
- FC-SEMS-in-FC-SEMS技术为难以移除支架提供了一个潜在的解决方案.
研究的目的:
- 评估FC-SEMS-in-FC-SEMS技术的技术和临床成功情况.
- 评估FC-SEMS-in-FC-SEMS程序的安全情况.
- 为了确定与非恶性远部胆道狭窄的FC-SEMS移除失败相关的风险因素.
主要方法:
- 对2020年1月至2023年5月期间FC-SEMS删除ERCP程序的回顾性分析.
- 对接受FC-SEMS-in-FC-SEMS技术的患者进行评估.
- 统计分析以确定支架切除失败的风险因素.
主要成果:
- 在15名患者中,FC-SEMS-in-FC-SEMS技术取得了100%的技术和临床成功.
- 在15名患者中,有13名 (86.7%) 患者只需要一次治疗.
- 在50名患者中,FC-SEMS移除失败发生在30%的患者中,先前的支架和停留时间>300天是显著的风险因素.
结论:
- FC-SEMS-in-FC-SEMS技术是一种安全有效的方法来管理FC-SEMS移除故障.
- 尽量减少支架停留时间,特别是在有胆道支架病史的患者中,可能会减少去除失败的发生率.
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