内镜超声引导下前向和经腔支架植入术在ERCP失败后远端恶性胆道梗阻中的应用比较

IF 2 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY
Yonghua Shen, Ying Lv, Xiaojiao Zheng, Wei Zhan, Senlin Hou, Lin Zhou, Jun Cao, Bin Zhang, Lei Wang, Hao Zhu, Lichao Zhang
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There were no statistical differences in the malignancy type, baseline common bile duct diameter, total bilirubin level, reason for EUS-BD, and history of biliary drainage between TLS and AGS groups. 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引用次数: 0

摘要

背景。远端恶性胆道梗阻(DMBO)可导致梗阻性黄疸。内镜超声(EUS)引导胆道引流术(EUS-BD)是ERCP失败后治疗DMBO的一种替代方法。目的比较ERCP失败后无法切除的DMBO患者采用前向法和经内镜法的疗效和安全性。方法。本研究招募了ERCP失败后导致梗阻性黄疸的DMBO患者。我们回顾性评估了 EUS 引导下腔内支架植入术(TLS 组)和前向支架植入术(AGS 组)的安全性和有效性。结果。82例患者入组,其中TLS组45例,AGS组37例。TLS 组和 AGS 组在恶性肿瘤类型、基线胆总管直径、总胆红素水平、EUS-BD 原因和胆道引流史方面没有统计学差异。据统计,TLS 组的技术成功率高于 AGS 组(97.8% 对 81.1%)。TLS 组和 AGS 组在临床成功率、手术相关不良事件、支架移位率、支架功能障碍率、再介入率和患者总生存时间方面没有统计学差异。TLS 组和 AGS 组支架功能障碍或患者死亡的中位时间分别为 53 天和 81 天()。结论。虽然 AGS 的技术成功率低于 TLS,但在 DMBO 患者的支架通畅率方面却优于 TLS。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison between Endoscopic Ultrasound-Guided Antegrade and Transluminal Stent Implantation in Distal Malignant Biliary Obstruction after Failed ERCP
Background. Distal malignant biliary obstruction (DMBO) can result in obstructive jaundice. Endoscopic ultrasound- (EUS-) guided biliary drainage (EUS-BD) has been an alternative for DMBO after failed ERCP. Aim. To compare the efficacy and safety between antegrade and transluminal approaches in patients with unresectable DMBO when ERCP failed. Methods. Patients with DMBO leading to obstructive jaundice after failed ERCP were enrolled in this study. We retrospectively evaluated the safety and efficacy between EUS-guided transluminal stenting (TLS group) and antegrade stenting (AGS group). Results. 82 patients were enrolled, of which 45 patients were in TLS group and 37 in AGS group. There were no statistical differences in the malignancy type, baseline common bile duct diameter, total bilirubin level, reason for EUS-BD, and history of biliary drainage between TLS and AGS groups. The technical success rate was statistically higher in TLS group than in AGS group (97.8 vs. 81.1%, ). There were no statistical differences in clinical success rate, procedure-related adverse events, stent migration rate, stent dysfunction rate, reintervention rate, and overall patient survival time between TLS and AGS groups. The median time to stent dysfunction or patient death in TLS and AGS groups was 53 and 81 days, respectively (). Conclusions. Although AGS had a lower technical success rate than TLS, it was superior to TLS in stent patency in patients with DMBO.
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来源期刊
Gastroenterology Research and Practice
Gastroenterology Research and Practice GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
4.40
自引率
0.00%
发文量
91
审稿时长
1 months
期刊介绍: Gastroenterology Research and Practice is a peer-reviewed, Open Access journal which publishes original research articles, review articles and clinical studies based on all areas of gastroenterology, hepatology, pancreas and biliary, and related cancers. The journal welcomes submissions on the physiology, pathophysiology, etiology, diagnosis and therapy of gastrointestinal diseases. The aim of the journal is to provide cutting edge research related to the field of gastroenterology, as well as digestive diseases and disorders. Topics of interest include: Management of pancreatic diseases Third space endoscopy Endoscopic resection Therapeutic endoscopy Therapeutic endosonography.
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