内镜下胰管支架置入术后支架内移位的处理  

Treatment of proximal migration of stents after endoscopic retrograde pancreatic drainage

作　　者：张诚[1] 杨玉龙[1] 吴萍[1] 马跃峰[1] 张洪威[1] 林美举[1] 史力军[1] 李婧伊[1] 赵沐[1] 

机构地区：[1]大连大学附属中山医院胆道微创外科,116001

出　　处：《中华肝胆外科杂志》2014年第12期866-868,共3页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的 探讨内镜下胰管支架置入术后支架内移位的处理方法及安全性.方法 回顾性分析2011年5月至2014年5月我院245例内镜下胰管支架置入术后发生支架内移位的7例患者的临床资料.结果 内镜下胰管支架置入术后支架内移位发生率2.9％.其中支架移位至十二指肠乳头壶腹2例、移位至胰头部4例、移位至胰体部1例.7例内移位支架均成功取出,使用取石球囊取出5例,2例未取出的胰管支架使用取石网篮取出.术后出现高淀粉酶血症3例,药物治疗2～3d恢复正常.结论 胰管支架内移位是内镜下胰管支架置入术后罕见并发症,应用取石球囊及网篮取出内移位胰管支架是安全有效的.Objective To investigate the treatment and safety of proximal migration of pancreatic stents after endoscopic retrograde pancreatic drainage.Methods A retrospective analysis was carried out on the clinical data of 7 patients with proximal migration of pancreatic stents among 245 patients who underwent endoscopic retrograde pancreatic drainage from May 2011 to May 2014 in our hospital.Results The rate of proximal pancreatic stent migration after endoscopic retrograde pancreatic drainage was 2.9％.There were 2 patients with the pancreatic stent migrated to the major ampulla vater,4 patients to the pancreatic head,and 1 patient to the pancreatic body.In 5 patients the stents were successfully removed by stone-removing balloons.In 2 patients the stents were successfully removed by stone-removing baskets.In 3 patients hyperamylasemia developed after the treatment and these patients responded to drug treatment within 2 ～ 3 days.Conclusions Proximal migration of pancreatic stent is a rare complication after endoscopic retrograde pancreatic drainage.It is safe and efficacious to remove the proximally migrated pancreatic stents by stone-removing balloons and baskets after endoscopic retrograde pancreatic drainage.

关 键 词：胰管支架 内镜逆行胆胰管造影术 取石球囊 取石网篮 内移位 

分 类 号：R657.5[医药卫生—外科学]