首页|Endoscopic ultrasound-guided choledochoduodenostomies with fully covered self-expandable metallic stents
Endoscopic ultrasound-guided choledochoduodenostomies with fully covered self-expandable metallic stents
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NSTL
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维普
AIM:To investigate the long-term outcomes of endoscopic ultrasound-guided choledochoduodenostomy (EUS-CDS) with a fully covered self-expandable metallic stent (FCSEMS).METHODS:From April 2009 to August 2010,15 patients with distal malignant biliary obstructions who were candidates for alternative techniques for biliary decompression due to a failed endoscopic retrograde cholangiopancreatography (ERCP) were included.These 15 patients consisted of 8 men and 7 women and had a median age of 61 years (range:30-91 years).The underlying causes of the distal malignant biliary obstruction were pancreatic cancer (n =9),ampulla of Vater cancer (n =2),renal cell carcinoma (n =1),advanced gastric cancer (n =1),lymphoma (n =1),and duodenal cancer (n =1).RESULTS:The technical success rate of EUS-CDS with an FCSEMS was 86.7％ (13/15),and functional success was achieved in 100％ (13/13) of those cases.In two patients,the EUS-CDS failed because an FCSEMS with a delivery device could not be passed into the common bile duct.The mean duration of stent patency was 264 d.Early adverse events developed in three patients (3/13,23.1％),including self-limited pneumoperitoneum in two patients and cholangitis requiring stent reposition in one patient.During the follow-up period (median:186 d,range:52-388 d),distal stent migration occurred in four patients (4/13,30.8％).In 3 patients,the FCSEMS could be reinserted through the existing choledochoduodenal fistula tract.CONCLUSION:EUS-CDS with an FCSEMS is technically feasible and can lead to effective palliation of distal malignant biliary obstructions after failed ERCP.
Bile duct obstructionDrainageEndosonographySelf-expandable metallic stentNeoplasms
Tae Jun Song、Yil Sik Hyun、Sang Soo Lee、Do Hyun Park、Dong Wan Seo、Sung Koo Lee、Myung-Hwan Kim
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Department of Internal Medicine, Inje University Ilsan Paik Hospital, Koyang 411-706, South Korea
Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul 138-736, South Korea
NETL
NSTL
万方数据
维普
