内镜治疗胆肠吻合术后狭窄的有效性和安全性分析
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海军军医大学第一附属医院消化内科

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海南省院士创新平台科研专项项目(YSPTZX202029)


Analysis of the Efficacy and Safety of Endoscopic Treatment for biliary anastomotic strictures
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Department of Gastroenterology,The First Affiliated Hospital of Naval Medical University

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Academician Innovation Platform Research Project of Hainan Province

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    摘要:

    目的 评估内镜治疗在胆肠吻合术后狭窄患者中的有效性和安全性。方法 纳入2016年1月至2024年1月在上海长海医院因良性胆肠吻合口狭窄接受内镜治疗的患者。根据排除标准,最终53例纳入回顾性分析,主要观察内镜治疗方式、介入次数、技术成功率、胆肠吻合口狭窄复发时间、狭窄缓解率以及并发症发生情况。结果 53例患者共接受103次内镜治疗,技术成功率98.1%(101/103)。48例(47.5%)选择支架置入联合扩张治疗,40例(39.6%)选择仅支架置入治疗,13例(12.9%)选择仅扩张治疗。中位随访31.0(13.5,50.3)月后,6例患者因不满随访时间死亡被排除分析;37例(78.7%)胆肠吻合口狭窄缓解;10例(21.3%)胆肠吻合口狭窄复发。内镜治疗胆肠吻合口狭窄的患者,约6.2(3.5,7.9)月需要再次进行内镜干预治疗,内镜下中位介入1(1,2)次可达到胆肠吻合口狭窄缓解。并发症比例为12.9%(13/101),其中手术相关并发症发生率7.9%(8/101),支架相关性并发症发生率5.0%(5/101)。结论 内镜治疗作为胆肠吻合术后狭窄的保守治疗方法,具有较高的狭窄缓解率和可控的并发症风险,是一种重要的治疗手段。

    Abstract:

    Objective To evaluate the efficacy and safety of endoscopy in the treatment of biliary anastomotic strictures. Methods Patients who received endoscopic treatment for benign biliary anastomotic strictures in Shanghai Changhai Hospital from January 2016 to January 2024 were included. According to the exclusion criteria, 53 cases were included in the final retrospective analysis, which mainly observed the endoscopic treatment methods, the number of interventions, the technical success rate, the recurrence time of biliary anastomotic strictures, the rate of recurrence and the occurrence of complications. Results A total of 103 endoscopic treatments were performed on 53 patients, with a technical success rate of 98.1% (101/103). Treatment modalities included stent placement combined with dilation in 48 cases (47.5%), stent placement alone in 40 cases (39.6%), and dilation alone in 13 cases (12.9%). During a median follow-up of 31.0 (13.5,50.3) months, 6 patients were excluded from the analysis due to death before the follow-up period was completed; 37 cases (78.7%) showed alleviation of biliary-enteric anastomotic stricture; 10 cases (21.3%) experienced recurrence of biliary-enteric anastomotic stricture. On average, patients with anastomotic strictures required another endoscopic intervention approximately every 6.2 (3.5,7.9) months, with a median of 1 (1,2) endoscopic interventions needed for stricture resolution. The overall complication rate was 12.9% (13/101), with surgery-related complications occurring in 7.9% (8/101) and stent-related complications in 5.0% (5/101) of the cases. Conclusion Endoscopic treatment is an important conservative treatment method for anastomosis strictures, with a high rate of stricture resolution and manageable complications.

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陈航宇,杨婷,张平平,等.内镜治疗胆肠吻合术后狭窄的有效性和安全性分析[J].中华消化内镜杂志,,().

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  • 收稿日期:2024-08-02
  • 最后修改日期:2024-08-20
  • 录用日期:2024-08-21
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