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首页> 外文期刊>Gastrointestinal Endoscopy >A biodegradable non-covered self-expandable stent to treat?pancreatic duct strictures in chronic pancreatitis: a?proof?of principle
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A biodegradable non-covered self-expandable stent to treat?pancreatic duct strictures in chronic pancreatitis: a?proof?of principle

机译：可生物降解的非覆盖自膨胀支架治疗？慢性胰腺炎的胰管狭窄：a？证明？原则

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摘要

Background and Aims In chronic pancreatitis (CP), fibrotic pancreatic duct (PD) strictures pose a therapeutic challenge, because endoscopic dilatation requires multiple procedures with suboptimal results. Biodegradable self-expandable stents (BD-SESs) may serve as an alternative in this setting. Methods Patients with CP were eligible for this proof-of-principle study if at least 6 months of endoscopic dilatation with plastic stents had failed to resolve their PD stricture. The non-covered BD-SESs were expected to degrade within 3 to 6 months. Patients were followed at 3-monthly intervals for 1 year. Placement success and safety were the primary outcome parameters. Stricture resolution was assessed by ERCP after 6 months. Results BD-SESs were successfully placed in all 19 patients without adverse events. In 2 cases, stent occlusion with sludge and stones was treated by a balloon swipe. One stent disintegrated during this procedure, after which placement of the plastic stent was resumed. A hyperplastic response was observed in 2 patients but did not result in functional obstruction. Stricture resolution was accomplished in 11 patients (technical success rate 58%). Six patients required further treatment of their PD stricture, 4 endoscopically and 2 surgically. Three additional patients underwent surgery for other reasons: 2 Whipple procedures for CP-related adverse events and one tail resection for an intraductal papillary mucinous neoplasm. The remaining 10 patients did not require further PD drainage (clinical success rate 52%). Conclusions These preliminary results show that BD-SESs are safe to use and able to resolve fibrotic PD strictures in CP. These encouraging outcomes warrant further testing.
机译：背景和患有慢性胰腺炎（CP），纤维化胰管（PD）狭窄造成治疗挑战，因为内镜扩张需要具有次优效果的多种程序。可生物降解的自膨胀支架（BD-SESS）可以作为该设置中的替代品。方法如果与塑料支架的内窥镜扩张至少6个月未能解决其PD狭窄，则CP患者有资格获得此原则上的原则研究。预期的BD-SES预计将在3至6个月内降解。患者按3年间隔持续1年。放置成功和安全是主要的结果参数。在6个月后，ERCP评估了狭窄决议。结果BD-Sess成功置于19名没有不良事件的所有19名患者中。在2例中，通过气囊刷卡处理与污泥和石头的支架闭塞。在该过程中崩解的一块支架，之后恢复了塑料支架的放置。在2名患者中观察到增生响应，但未导致功能性阻塞。狭窄决议在11名患者中完成（技术成功率58％）。六名患者需要进一步治疗它们的PD狭窄，4患者，内窥镜和2例手术。另外三名患者因其他原因接受了手术：2个与乳头状粘液肿瘤的CP相关不良事件的乳剂程序和一个尾部切除。其余10名患者不需要进一步的PD排水（临床成功率52％）。结论这些初步结果表明，BD-SES可以安全地使用，并能够解决CP中的纤维化PD狭窄。这些令人鼓舞的结果需要进一步测试。

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  • 来源
    《Gastrointestinal Endoscopy》 |2018年第2期|共6页
  • 作者

    Djuna L. Cahen; Schalk W. van der Merwe; Wim Laleman; Jan-Werner Poley; Marco J. Bruno;

  • 作者单位

    Department of Gastroenterology and Hepatology Erasmus University Medical Center;

    Department of Gastroenterology and Hepatology University Hospital Leuven;

    Department of Gastroenterology and Hepatology University Hospital Leuven;

    Department of Gastroenterology and Hepatology Erasmus University Medical Center;

    Department of Gastroenterology and Hepatology Erasmus University Medical Center;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 消化系及腹部疾病;
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  • 入库时间 2022-08-20 03:04:13

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