Balloon Dilation-assisted Extraction of Embedded Self-Expandable Metal Stents.

IF 1.2 4区医学 Q4 GASTROENTEROLOGY & HEPATOLOGY

Acta gastro-enterologica Belgica Pub Date : 2025-04-01 DOI:10.51821/88.1.14150

M Bronswijk, A Reekmans, S van der Merwe

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引用次数: 0

Abstract

Background and study aims: Embedded transpapillary self-expandable metal stents (SEMS) may require extraction over time and standard approaches often fail. In the current study we describe a newly developed approach to refractory embedded SEMS, using balloon dilation-assisted extraction. Our aim was to evaluate the feasibility and outcomes of this novel technique.

Patients and methods: This is an exploratory single-center retrospective analysis of all consecutive patients undergoing endoscopic balloon-assisted stent extraction. Baseline, procedural and follow-up data were collected and analyzed.

Results: Twelve patients with embedded transpapillary SEMS were identified (60.0% female, mean age 70.1 [SD±18.1] years, uncovered SEMS 33.3%) with median dwell time of 457.5 (IQR 175.8-1042) days. Previous extraction attempts were undertaken in the majority of cases (83.3%), including SEMS-in-SEMS placement (41.7%). Using the balloon-assisted stent extraction technique, successful SEMS extraction was achieved in 10 out of 12 cases (83.3%). Adverse events occurred in 3 patients (Grade II [n=2, 16.7%] - Grade III [n=1, 8.3%]). After a median follow-up time of 171 (58-260) days, 1 biliary recurrence occurred for which endoscopic re-evaluation was performed.

Conclusions: Our data suggest that endoscopic balloonassisted stent extraction should be considered for extraction of embedded self-expandable metal stents, as it showed high efficacy without any major procedure-related adverse events, using readily available endoscopic tools.

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球囊扩张辅助取出内埋自膨胀金属支架。

背景和研究目的：随着时间的推移，嵌入式经乳头自膨胀金属支架（SEMS）可能需要拔出，而标准方法往往失败。在目前的研究中，我们描述了一种新开发的方法，使用球囊扩张辅助提取难熔嵌入SEMS。我们的目的是评估这种新技术的可行性和结果。患者和方法：这是一项探索性的单中心回顾性分析，纳入了所有连续接受内镜球囊辅助支架取出术的患者。收集和分析基线、程序和随访数据。结果：共发现12例包埋式经乳头SEMS患者（女性60.0%，平均年龄70.1 [SD±18.1]岁，未覆盖SEMS 33.3%），中位停留时间457.5 （IQR 175.8-1042）天。大多数病例（83.3%）都进行过拔牙尝试，包括SEMS-in-SEMS放置（41.7%）。采用球囊辅助支架提取技术，12例患者中有10例（83.3%）SEMS提取成功。3例患者发生不良事件（II级[n= 2,16.7%] - III级[n= 1,8.3%]）。中位随访时间为171（58-260）天，发生1例胆道复发，并进行了内镜下重新评估。结论：我们的数据表明，内镜下球囊辅助支架提取术应该被考虑用于取出嵌入的自膨胀金属支架，因为它显示出高效率，没有任何主要的手术相关不良事件，使用现成的内镜工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta gastro-enterologica Belgica Medicine-Gastroenterology

CiteScore

2.30

自引率

20.00%

发文量

期刊介绍： The Journal Acta Gastro-Enterologica Belgica principally publishes peer-reviewed original manuscripts, reviews, letters to editors, book reviews and guidelines in the field of clinical Gastroenterology and Hepatology, including digestive oncology, digestive pathology, as well as nutrition. Pure animal or in vitro work will not be considered for publication in the Journal. Translational research papers (including sections of animal or in vitro work) are considered by the Journal if they have a clear relationship to or relevance for clinical hepato-gastroenterology (screening, disease mechanisms and/or new therapies). Case reports and clinical images will be accepted if they represent an important contribution to the description, the pathogenesis or the treatment of a specific gastroenterology or liver problem. The language of the Journal is English. Papers from any country will be considered for publication. Manuscripts submitted to the Journal should not have been published previously (in English or any other language), nor should they be under consideration for publication elsewhere. Unsolicited papers are peer-reviewed before it is decided whether they should be accepted, rejected, or returned for revision. Manuscripts that do not meet the presentation criteria (as indicated below) will be returned to the authors. Papers that go too far beyond the scope of the journal will be also returned to the authors by the editorial board generally within 2 weeks. The Journal reserves the right to edit the language of papers accepted for publication for clarity and correctness, and to make formal changes to ensure compliance with AGEB’s style. Authors have the opportunity to review such changes in the proofs.