Which Are the Most Suitable Stents for Interventional Endoscopic Ultrasound?

被引:14
作者
Park, Se Woo [1 ]
Lee, Sang Soo [2 ]
机构
[1] Hallym Univ, Dongtan Sacred Heart Hosp, Coll Med, Div Gastroenterol,Dept Internal Med, Hwaseong Si 18450, South Korea
[2] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Gastroenterol, Seoul 05505, South Korea
关键词
endoscopic ultrasound; drainage; therapeutic; intervention; stents; GUIDED BILIARY DRAINAGE; APPOSING METAL STENT; PANCREATIC-DUCT DRAINAGE; PERIPANCREATIC FLUID COLLECTIONS; LONG-TERM OUTCOMES; TRANSHEPATIC GALLBLADDER DRAINAGE; DIRECTED TRANSGASTRIC ERCP; GASTRIC BYPASS ANATOMY; DOUBLE-WIRE TECHNIQUE; TRANSMURAL DRAINAGE;
D O I
10.3390/jcm9113595
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Endoscopic ultrasound (EUS)-guided interventions provide easy access to structures adjacent to the gastrointestinal tract, effectively targeting them for therapeutic purposes. They play an important role in the management of pancreatic fluid collections (PFC) and bile duct (BD) and pancreatic duct (PD) drainage in cases of failed endoscopic retrograde cholangiopancreatography (ERCP) or gallbladder (GB) drainage. Specially designed stents and delivery systems for EUS-guided transluminal interventions allow various new applications and improve the efficacy and safety of these procedures. In fact, EUS-guided drainage has emerged as the treatment of choice for the management of PFC, and recent innovations such as fully covered metal stents (including lumen-apposing metal stents) have improved outcomes in patients with walled-off necrosis. Similarly, EUS-guided BD and PD drainage with specially designed stents can be beneficial for patients with failed ERCP due to an inaccessible papilla, gastric outlet obstruction, or surgically altered anatomy. EUS-guided GB drainage is also performed using dedicated stents in patients with acute cholecystitis who are not fit for surgery. Although the field of dedicated stents for interventional EUS is rapidly advancing with increasing innovations, the debate on the most appropriate stent for EUS-guided drainage has resurfaced. Furthermore, some important questions remain unaddressed, such as which stent improves clinical outcomes and safety in EUS-guided drainage. Herein, the current status and problems of the available stents are reviewed, including the applicable indications, long-term clinical outcomes, comparison between each stent, and their future prospects.
引用
收藏
页码:1 / 23
页数:23
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