摘要
全覆膜自膨胀金属支架（FCSEMS）治疗肝移植术后胆管吻合口狭窄和慢性胰腺炎等因素导致的胆管良性狭窄的初步结果令人鼓舞,但在FCSEMS完全取代塑料支架成为胆管良性狭窄的治疗首选之前,应充分评估支架移位、胆道感染、胰腺炎和支架无法移除等并发症的发生率.对于良性的主胰管狭窄,FCSEMS是一种有效的治疗方法,但支架移位率较高,需要更好顺应性和末端喇叭口的支架设计.理论上讲,FCSEMS会堵塞分支胰管导致胰管感染,但目前并没有这些并发症的报道.由于FCSEMS治疗主胰管狭窄的长期有效性和安全性尚不清楚,FCSEMS使用应限制在治疗复发性和有症状的胰管良性狭窄.
Though the primary data on fully covered self-expandable metal stents （FCSEMS） in the treatment of benign biliary strictures caused by chronic pancreatitis and anastomotic stricture following orthotopic liver transplantation is encouraging, the risks including stent translocation, biliary infection, pancreatitis and inability to remove stents should be considered before replacing plastic stents with FCSEMS for the first-line treatment of benign biliary strictures in routine practice. FCSEMS is effective in treating benign pancreatic ductal strictures, but it is also associated with a high rate of stent translocation. To overcome this problem, FCSEMS with better con- formability and flared ends need to be designed. There is a theorectial risk of pancreatic ductal infection caused by the blockage of side branches of the pancreas by covering membrane of the stents. However, no such complication was reported. Given the uncertain long-term efficacy and safety of FCSEMS for benign pancreatic ductal strictures, their use may be reserved for the management of refractory, symptomatie benign strictures only in selected groups of patients.
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2014年第6期493-496,共4页
Chinese Journal of Digestive Surgery
基金
成都军区总医院院管课题（424121BJ）
关键词
胆胰管良性狭窄
治疗
支架
Benign biliary and pancreatic ductal strictures
Treatment
Stents
