胃十二指肠支架置入术

Gastroduodenal stent placement

胃出口梗阻是晚期胰腺、胃和十二指肠恶性肿瘤的一种晚期并发症。胃出口梗阻患者会出现难治性恶心、呕吐和厌食,进而可能导致电解质失衡、脱水和营养不良。此外,这些患者持续存在误吸和肺炎的风险。传统上,这些梗阻大多采用手术治疗。然而,许多患者由于初始评估时的身体状况不佳而不适合接受搭桥手术。此外,其发病率和死亡率显著较高,并与症状持续或延迟缓解和住院时间延长相关。球囊扩张术和金属支架置入已成功应用于不适合手术的患者。文章将对其适应证、禁忌证、技术、结果及争议进行综述。

Gastric outlet obstruction is a preterminal complication of advanced malignancies of the pancreas,stomach,and duodenum.Patients with gastric outlet obstruction experience intractable nausea,vomiting,and anorexia,which may in turn cause electrolyte imbalance,dehydration,and malnutrition.Furthermore,these patients are at constant risk for aspiration and pneumonia.Traditionally,most of these obstructions were treated surgically.Many patients,however,are unfit for bypass surgery because of poor medical condition at initial evaluation.Moreover,it carries a significant rate of morbidity and mortality and is associated with persistent or delayed relief of symptoms and prolonged hospital stay.Balloon dilation,as well as placement of metallic stents,has been applied successfully in patients who are not surgical candidates.In this review article,the indications,the contraindications,techniques,results,and controversies will be discussed.