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self-expandable metallic stent placement plus laparoscopy for acute malignant colorectal obstruction

World Journal of Gastroenterology 2013年第33期19卷 5513-5519页

作者： Jia-Min Zhou Li-Qing Yao Jian-Min Xu Mei-Dong Xu Ping-Hong Zhou Wei-Feng Chen Qiang Shi Zhong Ren Tao Chen Yun-Shi Zhong Department of Endoscopic Center Zhongshan HospitalFudan University Department of General Surgery Zhongshan HospitalFudan University

AIM:To investigate the clinical advantages of the stent-laparoscopy approach to treat colorectal cancer(CRC)patients with acute colorectal obstruction(ACO).METHODS:From April 2008 to April 2012,surgeryrelated parameters,complications,overall survival(OS),and disease-free survival(DFS)of 74 consecutive patients with left-sided CRC presented with ACO who underwent self-expandable metallic stent(SEMS)placement followed by one-stage open(n=58)or laparoscopic resection(n=16)were evaluated *** stent-laparoscopy group was also compared with a control group of 96 CRC patients who underwent regular laparoscopy without ACO between January 2010 and December 2011 to explore whether SEMS placement influenced the laparoscopic procedure or reduced long-term survival by influencing CRC oncological ***:The characteristics of patients among these groups were *** rate of conversion to open surgery was 12.5%in the stent-laparoscopy *** function recovery and postoperative hospital stay were significantly shorter(3.3±0.9 d vs 4.2±1.5 d and 6.7±1.1 d vs 9.5±6.7 d,P=0.016 and P=0.005),and surgical time was significantly longer(152.1±44.4 min vs 127.4±38.4 min,P=0.045)in the stent-laparoscopy group than in the stent-open ***-related complications and the rate of admission to the intensive care unit were lower in the stent-laparoscopy *** were no significant differences in the interval between stenting and surgery,intraoperative blood loss,OS,and DFS between the two stent *** with those in the stentlaparoscopy group,all surgery-related parameters,complications,OS,and DFS in the control group were ***:The stent-laparoscopy approach is a feasible,rapid,and minimally invasive option for patients with ACO caused by left-sided CRC and can achieve a favorable long-term prognosis.

关键词： self-expandable metallic stent Colorectal cancer Endoscopy Laparoscopy Efficiency Safety

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self-expandable metal stents in patients with postoperative delayed gastric emptying after distal gastrectomy

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World Journal of Gastroenterology 2018年第40期24卷 4578-4585页

作者： Seung Han Kim Bora Keum Hyuk Soon Choi Eun Sun Kim Yeon Seok Seo Yoon Tae Jeen Hong Sik Lee Hoon Jai Chun Soon Ho Um Chang Duck Kim Sungsoo Park Division of Gastroenterology and Hepatology Department of Internal MedicineInstitute of Gastrointestinal Medical Instrument ResearchKorea University College of MedicineSeoul 02841South Korea Department of Surgery Korea University College of MedicineSeoul 02841South Korea

AIM To investigate the efficacy and safety of endoscopic stent insertion in patients with delayed gastric emptying after *** In this study, we prospectively collected data from patients who underwent stent placement for delayed gastric emptying(DGE) after distal gastrectomy between June 2010 and April 2017, at a tertiary referral academic center. Clinical improvement, complications, and consequences after stent insertion were *** Technical success was achieved in all patients(100%). Early symptom improvement was observed in 15 of 20 patients(75%) and clinical success was achieved in all patients. Mean follow-up period was 1178.3 ± 844.1 d and median stent maintenance period was 51 d(range 6-2114 d). During the follow-up period, inserted stents were passed spontaneously per rectum without any complications in 14 of 20 patients(70%). Symptom improvement was maintained after stent placement without the requirement of any additional intervention in 19 of 20 patients(95%).CONCLUSION Endoscopic stent placement provides prompt relief of obstructive symptoms. Thus, it can be considered an effective and safe salvage technique for post-operative DGE.

关键词： self-expandable metal stent Delayed gastric emptying Gastrectomy Salvage technique Symptom improvement

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Development of a biliary multi-hole self-expandable metallic stent for bile tract diseases: A case report

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World Journal of Clinical Cases 2019年第11期7卷 1323-1329页

作者： Makoto Kobayashi Division of Gastroenterology Yokkaichi Municipal Hospital

BACKGROUND Uncovered stents used for malignant obstructions in the biliary tree, especially in the hilar area, are prone to obstruction by tumor ingrowths. In comparison, however, covered stents may block bile duct branches and are at risk of migration. We have developed a multi-hole self-expandable metallic stent (MHSEMS), with a hole in each cell, to prevent the obstruction of bile duct branches. In addition, the holes may prevent migration due to small ingrowths by reducing the tension of the membrane. CASE SUMMARY MHSEMS were placed in five patients with a malignant obstruction and one with post-endoscopic sphincterotomy bleeding. Each MHSEMS was successfully deployed in all cases. Patients showed no complications. Two cases were reviewed. Case 1: A 74-year-old male presented with jaundice and was diagnosed with a sigmoid colon cancer and giant liver metastases in the right liver lobe. A MHSEMS was placed in the left bile duct. The jaundice improved and peroral cholangioscopy was performed. Case 2: A 90-year-old female was admitted to hospital for jaundice and diagnosed with cholangiocarcinoma. A MHSEMS was placed in the left bile duct but after 8 months the stent became obstructed by tumor ingrowth. We treated the patient by ablation therapy. A silicone cover separated the internal bile duct from the surrounding tissue, protecting the latter from thermal injury during treatment by endobiliary ablation of the reobstruction. CONCLUSION A MHSEMS is a new choice of stent for biliary tract diseases.

关键词： Multi-hole self-expandable metallic stent Malignant biliary stricture Benign biliary stricture Hilar biliary obstruction Distal biliary obstruction Endobiliary radiofrequency ablation Case report

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Resolution of an esophageal leak and posterior gastric wall necrosis with esophageal self-expandable metal stents

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World Journal of Gastroenterology 2013年第40期19卷 6931-6933页

作者： Majid A Almadi Abdulrahman M Aljebreen Fahad Bamihriz Division of Gastroenterology King Khalid University Hospital King Saud University Riyadh 11461Saudi Arabia Division of Gastroenterology The McGill University Health Center Montreal General Hospital McGill UniversityMontrealH3G 1A4Canada Division of Surgery King Khalid University HospitalKing Saud UniversityRiyadh 11461Saudi Arabia

The use of weight reduction surgeries has increased over the years with a higher proportion of these surgeries being sleeve gastrectomies,this has been associated with some complications including staple line *** report a 32-year-old male who had undergone a laparoscopic gastric band surgery and subsequently a laparoscopic sleeve gastrectomy,this was complicated by both an staple line leak at the gastroesophageal junction as well as a large(> 4 cm) posterior gastric wall defect due to gastric wall necrosis. We used two co-axially inserted self-expandable stents(SEMS) in the management of this patient,5 stents were used over repeated endoscopy sessions and 20 wk. Both defects had resolved without the need for surgical *** is the first reported case were SEMS are used for both a staple line leak as well as a gastric wall *** also review the literature on the use of SEMS in the management of leaks post weight reduction surgeries.

关键词： Stents self-expandable metal stents Laparoscopic sleeve gastrectomy Staple line leak Esophageal leak Gastric necrosis

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Chronic pancreatic pain successfully treated by endoscopic ultrasound-guided pancreaticogastrostomy using fully covered self-expandable metallic stent

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World Journal of Clinical Cases 2016年第4期4卷 112-117页

作者： Arunchai Chang Pitulak Aswakul Varayu Prachayakul Siriraj Gastrointestinal Endoscopy Center Division of Gastroenterology Department of Internal Medicine Siriraj Hospital Faculty of Medicine Mahidol University Liver and Digestive Institute Samitivej Sukhumvit Hospital

One of the most common symptoms presenting in patients with chronic pancreatitis is pancreatic-type *** of the main pancreatic duct in chronic pancreatitis can be treated by a multitude of therapeutic approaches,ranging from pharmacologic,endoscopic and radiologic treatments to surgical *** the conservative treatment approaches fail to resolve symptomatic cases,however,endoscopic retrograde pancreatography with pancreatic duct drainage is the preferred second approach,despite its well-recognized *** the conventional transpapillary approach fails to achieve the necessary drainage,the patients may benefit from application of the less invasive endoscopic ultrasound(EUS)-guided pancreatic duct ***,we describe the case of a 42-year-old man who presented with severe abdominal pain that had lasted for 3 *** tomography scanning showed evidence of chronic obstructive pancreatitis with pancreatic duct stricture at *** conventional endoscopic retrograde pancreaticography failed to eliminate the symptoms,EUS-guided pancreaticogastrostomy(PGS)was applied using a fully covered,self-expandable,10-mm diameter metallic *** treatment resolved the case and the patient experienced no adverse ***-guided PGS with a regular biliary fully covered,self-expandable metallic stent effectively and safely treated pancreatictype pain in chronic pancreatitis.

关键词： Endoscopic ultrasound-guided Endoscopic ultrasound Pancreaticogastrostomy Pancreatic duct drainage Chronic pancreatitis self-expandable metallic stent

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self-expandable metal stents for achalasia: Thinking out of the box!

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World Journal of Gastrointestinal Endoscopy 2015年第1期7卷 45-52页

作者： Athanasios D Sioulas Chrysoula Malli George D Dimitriadis Konstantinos Triantafyllou Hepatogastroenterology Unit Second Department of Internal Medicine and Research InstituteAttikon University General HospitalMedical SchoolAthens University12462 HaidariGreece

Achalasia is a primary motor disorder of the esophagus diagnosed manometrically in the clinical setting of dysphagia to both solids and liquids. Currently established treatment options include pneumatic dilation, laparoscopic Heller myotomy, botulinum toxin injection performed endoscopically, oral agents that relax the lower esophageal sphincter and esophagectomy for refractory, end-stage disease. Despite their effectiveness, a significant proportion of patients eventually relapses and needs retreatment. In this setting, several new techniques are under investigation promising future enrichment of our therapeutic armamentarium for achalasic patients. Among them, peroral endoscopic myotomy and selfexpandable metal stents placed across the gastroesophageal junction represent the most encouraging modalities, as initial studies assessing their efficacy and safety indicate. This review highlights the role of selfexpandable metal stents in the management of patients with achalasia. Their possible position in the therapeutic algorithm of achalasia along with established and novel techniques is also assessed. Finally, the need for large prospective randomized trials is underlined in order to elucidate the numerous relevant issues.

关键词： Achalasia self-expandable metal stents Dysphagia Endoscopy Treatment

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Case of arterial hemorrhage after endoscopic papillary large balloon dilation for choledocholithiases using a covered self-expandable metallic stent

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World Journal of Gastroenterology 2015年第16期21卷 5090-5095页

作者： Shuya Shimizu Itaru Naitoh Takahiro Nakazawa Kazuki Hayashi Katsuyuki Miyabe Hiromu Kondo Yuji Nishi Shuichiro Umemura Yasuki Hori Akihisa Kato Hirotaka Ohara Takashi Joh Department of Gastroenterology and Metabolism Nagoya City University Graduate School of Medical Sciences Department of Community-based Medical Education Nagoya City University Graduate School of Medical Sciences

A 78-year-old male was admitted to our hospital because of *** demonstrated choledocholithiases with a maximum diameter of 13 mm, and we performed endoscopic papillary large balloon dilation(EPLBD) with a size of 15 *** following the balloon deflation, spurting hemorrhage occurred from the orifice of the duodenal *** we performed endoscopic hemostasis by compressing the bleeding point with the large balloon catheter, we could not achieve ***, we placed a 10 mm fully covered selfexpandable metallic stent(SEMS) across the duodenal papilla, and the hemorrhage stopped *** 1 wk of SEMS placement, duodenal endoscopy revealed ulcerative lesions in both the orifice of the duodenal papilla and the lower bile duct.A direct peroral cholangioscopy using an ultra-slim upper endoscope revealed a visible vessel with a longitudinal mucosal tear in the ulceration of the lower bile *** believe that the mucosal tear and subsequent ruptured vessel were caused by the EPLBD procedure.

关键词： Endoscopic papillary large balloon dilation Hemorrhage Covered self-expandable metallic stent Direct peroral cholangioscopy Endoscopic hemostasis

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Management of post-gastrectomy anastomosis site obstruction with a self-expandable metallic stent

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World Journal of Gastroenterology 2015年第16期21卷 5110-5114页

作者： Ra Ri Cha Sang Soo Lee Hyunjin Kim Hong Jun Kim Tae-Hyo Kim Woon Tae Jung Ok Jae Lee Kyung Soo Bae Sang-Ho Jeong Chang Yoon Ha Department of Internal Medicine Gyeongsang National University School of Medicine Department of Radiology Gyeongsang National University School of Medicine Department of Surgery Gyeongsang National University School of Medicine

Post-gastrectomy anastomosis site obstruction is a relatively rare complication after a subtotal *** present a case of a 75-year-old man who underwent a truncal vagotomy, omental patch, gastrojejunostomy, and Braun anastomosis for duodenal ulcer perforation and a gastric outlet *** the 10 th postoperative day, the patient complained of abdominal discomfort and *** diagnosed post-gastrectomy anastomosis site obstruction by an upper gastrointestinal series and an upper endoscopic *** inserted a self-expandable metallic stent(SEMS) at the anastomosis *** stent was fully expanded after *** the day following the stent insertion, the patient began to eat, and his abdominal discomfort was *** paper describes the successful management of post-gastrectomy anastomosis site obstruction with temporary placement of a SEMS.

关键词： Efferent loop syndrome Postgastrectomysyndrome self-expandable metallic stent

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Clinical outcomes of self-expandable stent placement for benign esophageal diseases: A pooled analysis of the literature

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World Journal of Gastrointestinal Endoscopy 2015年第2期7卷 135-153页

作者： Emo E van Halsema Jeanin E van Hooft Department of Gastroenterology and Hepatology Academic Medical Center

AIM: To analyze the outcomes of self-expandable stent placement for benign esophageal strictures and benign esophageal leaks in the ***: The Pub Med, Embase and Cochrane databases were searched for relevant articles published between January 2000 and July 2014. Eight prospective studies were identified that analyzed the outcomes of stent placement for refractory benign esophageal strictures. The outcomes of stent placement for benign esophageal leaks, perforations and fistulae were extracted from 20 retrospective studies that were published after the inclusion period of a recent systematic review. Data were pooled and analyzed using descriptive ***: Fully covered self-expandable metal stents(FC SEMS)(n = 85), biodegradable(BD) stents(n = 77) and self-expandable plastic stents(SEPS)(n = 70) were inserted in 232 patients with refractory benign esophageal strictures. The overall clinical success rate was 24.2% and according to stent type 14.1% for FC SEMS, 32.9% for BD stents and 27.1% for SEPS. Stent migration occurred in 24.6% of cases. The overall complication rate was 31.0%, including major(17.7%) and minor(13.4%) complications. A total of 643 patients were treated with self-expandable stents mainly for postsurgical leaks(64.5%), iatrogenic perforations(19.6%), Boerhaave's syndrome(7.8%) and fistulae(3.7%). FC SEMS and partially covered SEMS were used in the majority of patients. Successful closure of the defect was achieved in 76.8% of patients and according to etiology in 81.4% for postsurgical leaks, 86.0% for perforations and 64.7% for fistulae. The pooled stent migration rate was 16.5%. Stent-related complications occurred in 13.4% of patients, including major(7.8%) and minor(5.5%) ***: The outcomes of stent placement for refractory benign esophageal strictures were poor. However, randomized trials are needed to put this into perspective. The evidence on successful stent placement for benign esophageal leaks,

关键词： self-expandable stents Benign esophagealstrictures Esophageal perforation Esophageal fistula Anastomotic leak Systematic review

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Fully covered self-expandable metal stents for treatment of malignant and benign biliary strictures

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World Journal of Gastrointestinal Endoscopy 2012年第9期4卷 405-408页

作者： Ahmed Abdel Samie Stephan Dette Ulrich Vhringer Michael Stumpf Karolin Kopischke Lorenz Theilmann Department of Gastroenterology Pforzheim HospitalKanzlerstr.2-675175 PforzheimGermany Department of Surgery Pforzheim HospitalKanzlerstr.2-675175 PforzheimGermany

AIM:To present a series of covered self-expandable metal stents(CSEMS) placed for different indications and to evaluate the effectiveness,complications and extractability of these ***:We therefore retrospectively reviewed the courses of patients who received CSEMS due to malignant as well as benign biliary strictures and postsphincterotomy bleeding in our endoscopic unit between January 2010 and October ***:Twenty-six patients received 28 stents due to different indications(20 stents due to malignant biliary strictures,six stents due to benign biliary strictures and two stents due to post-sphincterotomy bleeding).Biliary obstruction was relieved in all cases,regardless of the underlying *** could be achieved in the two patients who received the stents for this *** occurred in five patients(18%).Two patients(7%) developed cholecystitis,stents dislocated/migrated in other two patients(7%),and in one patient(3.6%) stent occlusion was documented during the study *** stents were extracted *** of stents was easily possible in all cases in which it was desired using standard *** patients underwent surgery with pylorus preserving *** all patients stents could be removed during the operation without ***:Despite the higher costs of these devices,fully covered self-expanding metal stents may be suitable to relief biliary obstruction due to bile duct stenosis,regardless of the underlying *** may also represent an effective treatment strategy of severe post-sphincterotomy bleeding,not controlled by other measures.

关键词： Completely covered self-expandable metal stents Pancreatic carcinoma Biliary stenosis

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