复杂性的胃、十二指肠支架成形术

Gastrointestinal stenting：the technique for difficulty cases

关键词:  恶性  上消化道梗阻  支架

Key words:  malignant  gastroduodenal obstruction  stent

摘要:

［目的］探讨不同途径植入胃、十二指肠支架解决复杂性的恶性胃、十二指肠梗阻的技巧及疗效。［方法］总结分析2002年12月～2008年2月较难处理的胃、十二指肠支架成形术病例31 例。其中经口途径植入支架26例，经胃造瘘导管植入支架3例，经肝途径植入支架2例。［结果］所有支架释放成功，病人均在术后第2天开始进流食，89.6%（26/29）的患者临床症状缓解，进食改善。所有患者中位生存期为4.5个月，随访期内均无支架移位及再狭窄的发生。［结论］选择不同途径植入胃、十二指肠支架可以较好地解决恶性上消化道梗阻。

Abstract:

［Objective］To evaluate the clinical technique and efficacy of three different ways to implant metallic stents for complex gastroduodenal obstruction.［Methods］Thirty-one cases of clinical difficulty gastroduodenal obstruction were reviewed.Twenty-six of them were treated with technique by per oral way.Two obstructions in the infra-ampullary part of the duodenum were treated by transhepatic way for difficult anatomy.One pyloric and two duodenal obstructions were treated by stent-placement with gastrostomy for the failure of per oral treatment.［Results］Thirty-one wallstents were implanted successfully. All the patients were given with liquid food intake.Neither restenosis or displacement was observed during the period of follow-up.The mid-term survival time was 4.5 months.［Conclusion］With reasonable technique and pathway application,complex gastrointestinal obstruction could be treated properly.