新型金属支架用于内镜超声引导下经胃胰周积液引流的临床研究

Endoscopic ultrasonography-guided transgastric drainage of pancreatic fluid collections with a novel lumen-apposing metal stent

目的评价临床应用新型哑铃状覆膜金属支架经胃引流胰周积液(PFC)的有效性和安全性。方法回顾性分析2015年9月至2017年4月期间长海医院应用新型哑铃状覆膜金属支架行内镜超声(EUS)引导下经胃引流PFC的46例患者病例和随访资料。结果46例患者共行49次穿刺引流,包括3例同时置入2枚支架的患者。操作成功率95.9%(47/49),总体并发症发生率31.8%(14/44),其中严重并发症2例,分别为延迟性出血和腹膜炎。再介入率22.7%(10/44),术后住院时间1~40 d,平均6 d。术后随访9~28个月,平均18.4个月,引流成功率90.9%(40/44),支架拔除时间为20~142 d,平均59.4 d,PFC复发率10.0%(4/40)。结论新型哑铃状覆膜金属支架用于EUS引导下PFC的经胃引流是有效和相对安全的。

Objective To evaluate the efficacy and safety of a novel lumen-apposing metal stent (LAMS) in endoscopic ultrasonography(EUS)-guided transgastric drainage of pancreatic fluid collections (PFC). Methods A retrospective study of 46 patients was performed who underwent EUS-guided transgastric drainage of PFC with placement of LAMS from September 2015 to April 2017. Clinical data were reviewed and follow-up data were obtained by telephone and outpatient contact. Results A total of 49 LAMS were placed in 46 patients ( 2 LAMS were placed in 3 patient respectively for multiport access ) . The operation success rate was 95. 9%( 47/49 ) , complications occurred in 14 patients ( 31. 8%) , including 2 severe complications ( delayed hemorrhage and peritonitis ) . Additional intervention was performed in 10 patients(22. 7%). The mean hospital stay was 6 days (1-40 days) and patients were followed for a mean time of 18. 4 months ( 9-28 months) . Treatment success was achieved in 40 patients( 90. 9%) . Stent removal was performed after a mean time of 59. 4 days ( 20-142 days) , and recurrence rate was 10%( 4/40) during the follow-up period. Conclusion Drainage of PFC using LAMS with special design is effective and relatively safe.