Separate支架在治疗胃十二指肠恶性梗阻中的应用

Application of separate stent placement in the treatment of malignant gastroduodenal obstruction

目的 探讨Separate支架置入术在姑息性治疗不能手术的胃肠道恶性梗阻的可行性和有效性。方法 34例患者采用经口置入Separate支架治疗不能手术的恶性胃十二指肠梗阻。梗阻的原因分别是胃癌 1 1例、胰腺癌 1 2例、转移性肿瘤 3例、胆道肿瘤 6例和十二指肠癌 2例。透视下分别将Separate支架的外层带膜支架和内层裸支架同轴重叠释放在狭窄病变处。结果 技术成功率为 97% ,未发生严重并发症。 33例患者胃肠道梗阻症状缓解或消失 ,在Separate支架置入后 ,患者进食能力评分平均从 3.8提高到 1 .2。随访期间未发现支架移位和肿瘤内生性生长等并发症 ,1例患者由于肿瘤浸润致支架近端梗阻复发 ,置入第 2枚支架。

Objective To evaluate the feasibility and efficacy of Separate stent placement in the palliative treatment of inoperable malignant gastroduodenal obstruction.Methods Thirty four consecutive patients with inoperable malignant gastroduoenal obstruction were treated with peroral placement of Separate stent. Gastroduodenal obstruction was caused by gastric ( n =11), pancreatic ( n =12), matastatic ( n =3), biliary duct ( n =6) or duodenal ( n =2) cancers. Separate outer partial covered stent overlapping with inner bare stent were placed coaxially under fluoroscopic guidance.Results The technical successful rate reached 97% (33 of 34) with no major complication. Symptoms of gastroduodenal obstruction relieved in 33 patients. The average score of food intake capacity improved from 3.8 to 1.2 after Separate stent placment. Stent migration and tumor ingrowth were not detected during the follow up period. Tumor overgrowth was confirmed in one patient and a second stent was placed to solve the problem.Conclusions Peroral placement of Separate stent is a feasible and effective treatment for patients with inoperable malignant gastroduodenal obstruction.