CAJ | 학술논문

全覆膜自膨胀金属支架(FCSEMS)治疗肝移植术后胆管吻合口狭窄和慢性胰腺炎等因素导致的胆管良性狭窄的初步结果令人鼓舞,但在FCSEMS完全取代塑料支架成为胆管良性狭窄的治疗首选之前,应充分评估支架移位、胆道感染、胰腺炎和支架无法移除等并发症的发生率.对于良性的主胰管狭窄,FCSEMS是一种有效的治疗方法,但支架移位率较高,需要更好顺应性和末端喇叭口的支架设计.理论上讲,FCSEMS会堵塞分支胰管导致胰管感染,但目前并没有这些并发症的报道.由于FCSEMS治疗主胰管狭窄的长期有效性和安全性尚不清楚,FCSEMS使用应限制在治疗复发性和有症状的胰管良性狭窄.
전복막자팽창금속지가(FCSEMS)치료간이식술후담관문합구협착화만성이선염등인소도치적담관량성협착적초보결과령인고무,단재FCSEMS완전취대소료지가성위담관량성협착적치료수선지전,응충분평고지가이위、담도감염、이선염화지가무법이제등병발증적발생솔.대우량성적주이관협착,FCSEMS시일충유효적치료방법,단지가이위솔교고,수요경호순응성화말단나팔구적지가설계.이론상강,FCSEMS회도새분지이관도치이관감염,단목전병몰유저사병발증적보도.유우FCSEMS치료주이관협착적장기유효성화안전성상불청초,FCSEMS사용응한제재치료복발성화유증상적이관량성협착.
Though the primary data on fully covered self-expandable metal stents (FCSEMS) in the treatment of benign biliary strictures caused by chronic pancreatitis and anastomotic stricture following orthotopic liver transplantation is encouraging,the risks including stent translocation,biliary infection,pancreatitis and inability to remove stents should be considered before replacing plastic stents with FCSEMS for the first-line treatment of benign biliary strictures in routine practice.FCSEMS is effective in treating benign pancreatic ductal strictures,but it is also associated with a high rate of stent translocation.To overcome this problem,FCSEMS with better conformability and flared ends need to be designed.There is a theorectial risk of pancreatic ductal infection caused by the blockage of side branches of the pancreas by covering membrane of the stents.However,no such complication was reported.Given the uncertain long-term efficacy and safety of FCSEMS for benign pancreatic ductal strictures,their use may be reserved for the management of retractory,symptomatic benign strictures only in selected groups of patients.