Safety and effectiveness of a long, partially covered metal stent for endoscopic ultrasound-guided hepaticogastrostomy in patients with malignant biliary obstruction

被引：91

作者：

Nakai, Yousuke ^{[1
]}

Isayama, Hiroyuki ^{[1
]}

Yamamoto, Natsuyo ^{[1
]}

Matsubara, Saburo ^{[1
,2
]}

Ito, Yukiko ^{[3
]}

Sasahira, Naoki ^{[4
]}

Hakuta, Ryunosuke ^{[1
,3
]}

Umefune, Gyotane ^{[1
,3
]}

Takahara, Naminatsu ^{[1
]}

Hamada, Tsuyoshi ^{[1
]}

Mizuno, Suguru ^{[1
]}

Kogure, Hirofumi ^{[1
]}

Tada, Minoru ^{[1
]}

Koike, Kazuhiko ^{[1
]}

机构：

[1] Univ Tokyo, Grad Sch Med, Dept Gastroenterol, Tokyo, Japan

[2] Tokyo Metropolitan Police Hosp, Dept Gastroenterol, Tokyo, Japan

[3] Japanese Red Cross Med Ctr, Dept Gastroenterol, Tokyo, Japan

[4] Tokyo Takanawa Hosp, Dept Gastroenterol, Tokyo, Japan

来源：

ENDOSCOPY | 2016年 / 48卷 / 12期

关键词：

ADVERSE EVENTS; FAILED ERCP; DRAINAGE; CHOLEDOCHODUODENOSTOMY; MIGRATION;

D O I：

10.1055/s-0042-116595

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background and study aims: Endoscopic ultrasound (EUS)-guided biliary drainage (EUS-BD) is potentially complicated by bile leak and stent migration. The aim of this study was to evaluate the safety and effectiveness of a long (>= 10 cm), partially covered metal stent (LP-CMS) for EUS-guided hepaticogastrostomy (EUS-HGS) for malignant biliary obstruction. Both the stent length and the uncovered portion at the proximal end of the LP-CMS are designed to prevent stent migration. Patients and methods: A total of 33 patients undergoing EUS-HGS using an LP-CMS in four centers were retrospectively studied. Technical and clinical success, adverse events, and recurrent biliary obstruction were evaluated. Results: Gastric outlet obstruction (76 %) and surgically altered anatomy (15 %) were two major reasons for EUS-HGS. The technical and clinical success rates were 100%. The median intragastric stent length was 54mm. The adverse event rate was 9%. No stent migration was observed. Recurrent biliary obstruction developed in 24%, with a median cumulative time to recurrence of 8.5 months. Conclusions: EUS-HGS using an LP-CMS for unresectable malignant biliary obstruction was safe and effective.

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页码：1125 / 1128

页数：4

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