Soehendra取架器在肝门部胆管狭窄多支架置入术中的应用  

Application of Soehendra Stent Retriever in Multiple Stents Placement for Hilar Biliary Stricture

作　　者：刘真真[1,2] 张银[1,3] 刘莉 文卫[1,4] 王敏[1] 范志宁 

机构地区：[1]南京医科大学第一附属医院,江苏省人民医院消化内镜中心,南京210029 [2]南京医科大学第二临床医学院,南京210000 [3]江苏省常州市第一人民医院消化内科,常州213003 [4]中国人民解放军第八一医院消化内科,南京210000

出　　处：《中国微创外科杂志》2016年第4期308-312,共5页Chinese Journal of Minimally Invasive Surgery

基　　金：国家自然科学基金(81172266);江苏省医学创新团队与领军人才基金项目(LJ201127);江苏省科技创新与成果转化专项资金项目(BL2012031)

摘　　要：目的探讨Soehendra取架器在肝门部胆管狭窄多支架置入术中调整支架移位的有效性。方法 2013年1月~2015年12月,对19例因肝门部胆管狭窄（包括15例无手术机会的恶性肝门部胆管狭窄,4例原位肝移植术后肝门部胆管狭窄）行内镜下多支架置入术中需要调整支架者,在支架置入后,用Soehendra取架器的前段沿导丝旋转拧紧进入支架的尾端,通过前推或后拉取架器调整支架位置,再逆向旋转退出取架器。评估支架调整的成功率和并发症。结果 19例支架位置调整均成功,无相关并发症。术后1周16例（84.2%）血直接胆红素较术前下降〉20%。结论 Soehendra取架器调整胆道支架的位置是安全可行的,可用于纠正支架在术中的移位。Objective To evaluate the technical feasibility and effectiveness of the Soehendra stent retriever for adjusting multiple stent placement. Methods From January 2013 to December 2015,19 patients with hilar biliary stricture were treated with multiple stents placement and needed to adjust the position of stents,including 15 patients with inoperable malignant hilar biliary stricture and 4 patients with previous orthotopic liver transplantation. After two or three plastic stents were placed in the liver hilum,the tip of the Soehendra stent retriever was screwed into the distal end of the stent along a guidewire to adjust the stent position.Technique success（ accurate placement） rate and complications were evaluated. Results Placement and adjustment of the stents were successful in all the 19 patients. There were no ERCP-related complications. One week after operation,the direct bilirubin was decreased by more than 20% in 16 cases（ 84. 2%）. Conclusions Use of the Soehendra stent retriever to adjust stent position is technically feasible and safe. It can be used to correct stents migrating proximally during ERCP procedure.

关 键 词：肝门部胆管狭窄 Soehendra取架器 塑料支架 内镜逆行胰胆管造影 

分 类 号：R657.4[医药卫生—外科学]