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首页> 外文期刊>Endoscopy International Open >Endoscopic treatment of large pancreatic fluid collections (PFC) using self-expanding metallic stents (SEMS) – a two-center experience
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Endoscopic treatment of large pancreatic fluid collections (PFC) using self-expanding metallic stents (SEMS) – a two-center experience

机译：使用自扩张金属支架（SEMS）的内镜治疗大型胰腺液集合（PFC）–两中心经验

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Background/study aim: During the last several years, endoscopic ultrasound (EUS)-guided pancreatic fluid collections’ (PFC) drainage has evolved into the preferred drainage technique. Recently, self-expanding metallic stents (SEMS) have been used as an alternative to double pigtail stents, with the advantage of providing a larger diameter fistula, thereby decreasing the risk of early obstruction and also allowing for direct endoscopic exploration of the cavity. The aim of this study was to evaluate the technical and clinical success, safety, and outcome of patients undergoing EUS-guided drainage of complex PFC using SEMS. Patients/materials and methods: The study was conducted at two tertiary hospitals from January 2010 to January 2013. All patients with PFC referred for endoscopic drainage were enrolled in a prospective database. The inclusion criteria were: (1) patients with pseudocysts or walled-off necrosis based on the revised Atlanta classification; (2) symptomatic patients with thick PFC; (3) PFC that persisted more than 6 weeks; and (4) large PFC diameter (≥?9?cm). The exclusion criteria consisted of coagulation disorders, PFC bleeding or infection, and failure-to-inform written consent. Results: A total of 16 patients (9 females, 7 males; mean age 52.6, range 20?–?82) underwent EUS drainage with SEMS.?There were 14 cases of pseudocysts and 2 cases of walled-off necrosis. The etiologies of the PFC were mainly gallstones (8 of 16 patients, 50?%) and alcohol (5 of 16 patients, 31?%). Technical success was achieved in 100?% of the cases. All patients had a complete resolution of the PFC. Conclusion: Transmural EUS-guided drainage of complex PFC using SEMS is feasible, appears safe, and is efficacious. However, the exchange of the UC (uncovered)-SEMS for plastic stents is mandatory within 1 week. Future prospective studies, preferably multicenter studies, comparing SEMS versus traditional plastic stents for the drainage of PFC are warranted.
机译：背景/研究目标：在过去的几年中，以内窥镜超声（EUS）引导的胰液收集（PFC）引流已发展成为首选的引流技术。近来，自膨胀金属支架（SEMS）已被用作双尾纤支架的替代选择，其优点是提供了较大的瘘管直径，从而降低了早期阻塞的风险，并且还允许通过内窥镜直接探查腔体。这项研究的目的是评估接受EEMS引导使用SEMS进行复杂PFC引流的患者的技术和临床成功率，安全性和结果。患者/材料和方法：该研究于2010年1月至2013年1月在两家三级医院进行。所有因内镜引流而转诊的PFC患者均纳入了前瞻性数据库。纳入标准为：（1）基于修订的亚特兰大分类的假性囊肿或壁坏死患者; （2）有症状的PFC增厚患者; （3）PFC持续超过6周; （4）PFC直径大（≥？9？cm）。排除标准包括凝血障碍，PFC出血或感染以及未告知书面同意书。结果：共有16例患者（9例女性，7例男性;平均年龄52.6，范围20-82）通过EEMS引流EUS。假性囊肿14例，壁坏死2例。 PFC的病因主要是胆结石（16例中有8例，占50％）和酒精（16例中5例，占31％）。 100％的案例获得了技术成功。所有患者均具有PFC的完全缓解。结论：采用EEMS的经壁EUS引导的复杂PFC引流是可行的，看起来安全且有效。但是，必须在1周内将UC（未发现）-SEMS换成塑料支架。将来有必要进行前瞻性研究，最好是多中心研究，以比较SEMS与传统塑料支架引流PFC的情况。

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