内窥镜超声引导下的胃空肠吻合术,使用管状全覆盖自膨胀金属支架,无需事先进行肠道填充。

IF 2.1 Q3 GASTROENTEROLOGY & HEPATOLOGY Clinical Endoscopy Pub Date : 2024-03-01 Epub Date: 2023-07-03 DOI:10.5946/ce.2023.022
Hakan Şentürk, İbrahim Hakkı Köker, Koray Koçhan, Sercan Kiremitçi, Gülseren Seven, Ali Tüzün İnce
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引用次数: 0

摘要

背景/目的:内窥镜超声引导下的胃空肠吻合术是一种治疗胃出口梗阻的微创方法。传统的方法是使用腔隙贴合金属支架(LAMS)进行吻合。然而,LAMS 价格昂贵,且并不普及。在本报告中,我们介绍了一种用于此目的的管状全覆盖自膨胀金属支架(T-FCSEMS):本研究共纳入 21 名患者(15 名男性 [71.4%];中位年龄 66 岁;年龄范围 40-87 岁)。共观察到 19 例恶性病例(12 例胰腺癌、6 例胃癌和 1 例转移性直肠癌)和 2 例良性病例。用 19 G 的针头穿刺空肠近端。用 6 F 膀胱切开器扩张胃壁和空肠壁,并植入 20×80 毫米聚四氟乙烯 T-FCSEMS (Hilzo)。12至18小时后开始口服,48小时后开始进食固体食物:中位手术时间为 33 分钟(23-55 分钟不等)。两周后,19 名患者可耐受口服喂食。恶性肿瘤患者的中位生存时间为 118 天(41-194 天)。无严重并发症或死亡病例发生。所有恶性肿瘤患者均能耐受口服食物,直至去世:结论:T-FCSEMS 安全有效。结论:T-FCSEMS 安全有效,应考虑将其作为 LAMS 治疗胃出口梗阻的替代方案。
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Endoscopic ultrasound-guided gastrojejunostomy with a direct technique without previous intestinal filling using a tubular fully covered self-expandable metallic stent.

Background/aims: Endoscopic ultrasonography-guided gastrojejunostomy is a minimally invasive method for the management of gastric outlet obstruction. Conventionally, a lumen-apposing metal stent (LAMS) is used to create an anastomosis. However, LAMS is expensive and not widely available. In this report, we described a tubular fully covered self-expandable metallic stent (T-FCSEMS) for this purpose.

Methods: Twenty-one patients (15 men [71.4%]; median age, 66 years; range, 40-87 years) were included in this study. A total of 19 malignant (12 pancreatic, 6 gastric, and 1 metastatic rectal cancer) and 2 benign cases were observed. The proximal jejunum was punctured with a 19 G needle. The stomach and jejunum walls were dilated with a 6 F cystotome, and a 20×80 mm polytetrafluoroethylene T-FCSEMS (Hilzo) was deployed. Oral feeding was initiated after 12 to 18 hours and solid foods after 48 hours.

Results: The median procedure time was 33 minutes (range, 23-55 minutes). After two weeks, 19 patients tolerated oral feeding. In patients with malignancy, the median survival time was 118 days (range, 41-194 days). No serious complications or deaths occurred. All patients with malignancy tolerated oral food intake until they expired.

Conclusion: T-FCSEMS is safe and effective. This stent should be considered as an alternative to LAMS for gastric outlet obstruction.

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来源期刊
Clinical Endoscopy
Clinical Endoscopy GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
4.40
自引率
8.00%
发文量
95
审稿时长
26 weeks
期刊最新文献
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