全覆膜自膨式金属支架在胆囊切除术后良性胆管狭窄的治疗体会

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1、全覆膜自膨式金属支架在胆囊切除术后良性胆管狭窄的治疗体会保定市第一屮心医院河北保定071000［摘要］目的探讨全覆膜自膨式金属支架在胆囊切除术后良性胆管狭窄的应用。方法回顾丫2013年1月-2015年1月我院12例胆囊切除术后良性胆管狭窄行全覆膜膨式佥属胆道支架治疗的患者，包括12个月的屮期随访结果。结果所有12例(100%)均成功放置，支架放置时间平均185±14天。支架放置期间相关的不良事件.•3例(25%)出现疼痛，2例(16.7%)出现胆管炎，1例(8.3%)出现胆结石，1例(8.3%)出现无症状性移

2、位。12例(100%)均成功回收支架。拔出支架后每3个月随访1次，平均随访时间12.5&plUSmn;1.3个月，1例(8.3%)病人出现再狭窄，转由外科治疗，平均12.5个月治疗有效率为91.7%。结论全覆膜自膨式金属支架是治疗胆囊切除术后良性胆管狭窄的安全、有效方法。［关键词］内镜逆行胰胆管造影，全覆膜自膨式金属支架，胆囊切除术后良性胆管狭窄，并发症，随访【屮图分类号】R575.7【文献标识码】A【文章编号】1001-5213(2016)09-0035-01Useoffullycoveredself-expandabl

3、emetalstentsforendoscopicmanagementofbenignbiliarystrictureaftercholecystectomy［Abstract］Objective:Evaluationoffullycoveredself-expandablemetalstentsinpostcholecystectomybileductstrictures.Methods:Weretrospectivelyreviewedthedataof12patients(Jan2013toJan2015)whoun

4、derwentendoscopictreatmentoffullycoveredself-expandablemetalstentsforbenignbiliarystricturesafterchoIecystectomyandthefollow-updatafromthepatients,includingthemid-termoutcomesof12months.RESULT:FCSEMSwereplacedin12patientsofbenignbiliarystrictureaftercholecystectom

5、y.Themedianperiodofendotherapywas185±14days,Stent-relatedadverseeventsoverthecourseofFCSEMSindwell:3patients(25%)moderateabdominalpain,2patients(16.7%)developedmildormoderatecholangitis,1case(8.3%)ofcholedochotomy,1asymptomaticcase(8.3%)ofmigrationwithoutth

6、eneedforintervention.EndoscopicremovalofFCSEMSwassuccessfullyperformedfor12patients(100%).Themedianperiodoffollow-upwas12.5±1.3months.Thepatientswerefollowed-upevery3monthsafterwithdrawingstent.Overpostindwellfollow-upperiod1patient(8.3%)developedrecurrents

7、tricturesandreceivedsurgicaltreatment.Overamedianfollow-upof12.5months,therateofstrictureresolutionwas91.7%.CONCLUSIONS:FCSEMSisthesafeandeffectivetreatmentofbenignbiliarystrictureaftercholecystectomy.[Keywords]Endoscopicretrogradecholangiopancreatography,Coveredm

8、etallicstents,Postcholecystectomybileductstricture,Complications,Followup随着胆囊切除术的病例增加，良性胆道狭窄的发病率也随之增加。内镜支架置入治疗狭窄的复发率较低，成本更低，并降低总体发病率和死亡率[1】。我们自2013年1月-2