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Duodenal and aortic stenting for aortoduodenal fistula secondary to malignancy:A case report 认领 引用
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作者 Siu-Tung Chan Samuel Tsoon Wuan Lo +2 位作者 Vanessa Wan Suen Cheung Carmen Chik Wah Chu Skyi Yin Chun Pang 《World Journal of Gastrointestinal Endoscopy》 2026年第5期43-48,共6页
BACKGROUND Aortoduodenal fistula(ADF)managed with duodenal stenting has never before been reported in the literature.CASE SUMMARY A 75-year-old Chinese female with metastatic ureteric carcinoma presented with massive ... BACKGROUND Aortoduodenal fistula(ADF)managed with duodenal stenting has never before been reported in the literature.CASE SUMMARY A 75-year-old Chinese female with metastatic ureteric carcinoma presented with massive gastrointestinal bleeding secondary to ADF.Initial haemorrhage was managed with endovascular aortic repair and endoscopic haemostasis.However,she refused definitive open surgery.Her duodenal fistula was managed with partially covered stenting of the duodenum,which was complicated with duodenal stent migration.The duodenal stent was removed and replaced,and fixed in place with endoclips.She tolerated oral feeding until she passed away two months later.CONCLUSION This case report demonstrates that combined endoscopic and endovascular management of ADF can be feasible in selected patients. 展开更多
关键词 Aorto-duodenal fistula Endovascular aortic repair Endoscopic stenting Stent migration,Complication Case report
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Efficacy and safety of early pancreatic duct stenting for unresectable pancreatic cancer: A randomized controlled trial 认领 引用 被引量：2
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作者 Min-Hui Sun Hong-Zhang Shen +2 位作者 Hang-Bin Jin Jian-Feng Yang Xiao-Feng Zhang 《World Journal of Gastrointestinal Oncology》 SCIE 2025年第4期233-242,共10页
BACKGROUND Palliative care for unresectable pancreatic cancer(PC)focuses mainly on the symptoms of the disease,including abdominal pain,obstructive jaundice,and malnutrition.Biliary stent placement using endoscopic re... BACKGROUND Palliative care for unresectable pancreatic cancer(PC)focuses mainly on the symptoms of the disease,including abdominal pain,obstructive jaundice,and malnutrition.Biliary stent placement using endoscopic retrograde cholangiopan-creatography(ERCP)to relieve biliary obstruction has become an internationally recognized treatment.Although a few studies have evaluated the efficacy of endoscopic pancreatic duct stenting in advanced PC,no consensus exists on the use of endoscopic treatment to relieve pain and improve nutritional status.METHODS Patients with unresectable PC were recruited.The participants were randomized into two groups:The double-stent group underwent ERCP with a fully-covered self-expandable metallic biliary stent(FCSEMS)and a pancreatic duct stent,while the single-stent group underwent ERCP with an FCSEMS only.Abdominal pain,nutritional status,and incidence of adverse events were compared between the two groups using the SPSS software.RESULTS Seventy-eight patients with unresectable PC were included in the analysis(40 and 38 in the double-and single-stent groups,respectively).The median pain scores of patients in the double-stent group were lower than those in the single-stent group at 1(0 vs 2.5,P=0.002),2(0 vs 3,P<0.001),3(0 vs 4,P<0.001),and 6 months(0 vs 4,P<0.001)after ERCP.Total serum protein levels in patients in the double-stent group were higher than those in the single-stent group(66.6±8.4 g/L vs 60.4±4.0 g/L,P=0.046)6 months postoperatively.The body mass index(BMI)of patients in both groups decreased at six months.However,the BMI in the single-stent group was higher than that in the double-stent group(P<0.001).CONCLUSION Early pancreatic duct stenting reduces abdominal pain and improves nutritional status in patients with unre-sectable PC without reducing the technical success rate or increasing the incidence of adverse events. 展开更多
关键词 Abdominal pain Nutritional status Pancreatic duct stenting Unresectable pancreatic cancer Endoscopic retrograde cholangiopancreatography
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Enhancing palliative care in malignant obstructive jaundice:A critical care perspective on endoscopic biliary stenting 认领 引用 被引量：1
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作者 Yun Xie Hui Xie Rui-Lan Wang 《World Journal of Gastrointestinal Surgery》 SCIE 2025年第3期431-434,共4页
This letter responds to Wang et al's recent publication on endoscopic biliary stenting for malignant obstructive jaundice(MOJ)by offering constructive feedback and suggestions for future research.We commend the au... This letter responds to Wang et al's recent publication on endoscopic biliary stenting for malignant obstructive jaundice(MOJ)by offering constructive feedback and suggestions for future research.We commend the authors for their comprehensive study design and execution,which included a clear delineation of study groups and a robust set of outcome measures.We suggest that future studies incorporate additional biomarkers,such as serum levels of liver enzymes and bilirubin,to provide a more nuanced understanding of liver function changes post-intervention.The study's focus on short-term survival rates is appreciated,but we recommend exploring longer-term follow-up periods to capture the full spectrum of survival outcomes.Additionally,the inclusion of quality of life assessments using validated instruments could offer a more holistic view of patient outcomes.From a critical care perspective,we advocate for the integration of advanced imaging techniques to better characterize biliary anatomy and potentially predict treatment response or complications.We believe that incor-porating these suggestions could enhance the understanding of endoscopic biliary stenting's role in MOJ management and its impact on patient outcomes,influ-encing future clinical guidelines and practice. 展开更多
关键词 Malignant obstructive jaundice Endoscopic biliary stenting Palliative care Critical care Liver function Quality of life
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Practical guide to duodenal stenting for gastric outlet obstruction:Clinical outcomes,selection criteria,placement techniques,and management strategies 认领 引用 被引量：2
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作者 Sakue Masuda Chikamasa Ichita Kazuya Koizumi 《World Journal of Gastrointestinal Endoscopy》 2025年第6期26-36,共11页
Duodenal stenting is a widely used palliative treatment for gastric outlet obstru-ction(GOO)caused by unresectable malignancies.Compared to surgical gastroje-junostomy,duodenal stenting allows for earlier oral intake,... Duodenal stenting is a widely used palliative treatment for gastric outlet obstru-ction(GOO)caused by unresectable malignancies.Compared to surgical gastroje-junostomy,duodenal stenting allows for earlier oral intake,shorter hospita-lization,and earlier chemotherapy initiation.However,its long-term efficacy is limited by stent occlusion,which typically occurs 2-4 months post-procedure,due to tumor ingrowth,overgrowth,or food impaction.Covered stents can reduce tumor ingrowth but increase the migration risk,particularly in patients receiving chemotherapy.This review provides a comprehensive comparison of duodenal stenting,surgical gastrojejunostomy,and endoscopic ultrasound-guided gastroen-terostomy,by discussing their clinical outcomes,advantages,and limitations.We further explore stent selection based on stricture characteristics,optimal placement techniques,post-procedural management,and for handling complic-ations including occlusion,migration,bleeding,and perforation.Additionally,we address technical challenges and troubleshooting strategies,including mana-gement of guidewire-induced perforation,incomplete stent expansion,and bile duct obstruction for overlapping biliary and duodenal stricture cases.Despite its widespread clinical use,no prior review has comprehensively covered both the technical and clinical aspects of duodenal stenting so extensively.By providing a clinically oriented,practical guide,this review serves as a valuable resource for endoscopists and gastroenterologists,facilitating optimized decision-making and improved outcomes for patients with GOO in real-world practice. 展开更多
关键词 Duodenal stenting Gastric outlet obstruction Endoscopic management Stentrelated complications Palliative care Trouble-shooting
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Overview of endoscopic biliary stenting in malignant obstructive jaundice 认领 引用 被引量：1
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作者 Hui Wang Yan Jiao +1 位作者 Qiang Ma Ya-Hui Liu 《World Journal of Gastrointestinal Surgery》 SCIE 2025年第2期20-24,共5页
This article discusses Wang et al’s essay.Endoscopic biliary stenting,a less invasive alternative to surgery,is effective for malignant obstructive jaundice.This article summarizes the pathophysiology of biliary obst... This article discusses Wang et al’s essay.Endoscopic biliary stenting,a less invasive alternative to surgery,is effective for malignant obstructive jaundice.This article summarizes the pathophysiology of biliary obstruction,the technical aspects of stenting,and the clinical outcomes.By comparison of endoscopic stenting with percutaneous biliary drainage,improvements and complications are focused on.Additionally,patient selection for stenting and future advancements in stent technology are important.Overall,endoscopic biliary stenting is a valuable palliative option for patients with malignant jaundice,especially those ineligibles for surgery. 展开更多
关键词 Endoscopic biliary stenting Malignant Obstructive jaundice Surgery Percutaneous biliary drainage
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Efficacy and safety of combining intestinal stenting with laparoscopic surgery in colorectal cancer patients with acute intestinal obstruction 认领 引用 被引量：1
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作者 Yi-Na He Tian-Tian Zhao 《World Journal of Gastrointestinal Surgery》 SCIE 2025年第8期209-217,共9页
BACKGROUND Recently,intestinal stenting combined with laparoscopic surgery has received increasing attention as a treatment option for acute intestinal obstruction.However,its safety and efficacy have not yet been est... BACKGROUND Recently,intestinal stenting combined with laparoscopic surgery has received increasing attention as a treatment option for acute intestinal obstruction.However,its safety and efficacy have not yet been established.AIM To assess the efficacy and safety of combining intestinal stenting with laparoscopic surgery for the management of acute intestinal obstruction.METHODS Clinical data from 74 patients with colorectal cancer and acute intestinal obstruction,who were admitted to the emergency department of the authors’hospital between October 2023 and November 2024,were collected and analyzed.Patients were divided into two groups based on the surgical intervention:A control group(emergency open surgery,n=37)and a study group(intestinal stent implantation combined with laparoscopic surgery,n=37).Observation indicators included stent placement rate,obstruction relief rate,and stent-related complications.RESULTS Intestinal stent placement was 100%successful in the study group,all of whom experienced relief from obstruction while exhibiting a significantly lower rate of ostomy creation and a higher rate of primary anastomosis than in the control group,as well as less intraoperative blood loss,shorter time to flatus,and shorter hospital stay.The complication rate was 5.41%(2/37;bleeding and re-obstruction),with no statistically significant difference between the two groups in terms of operative duration or perioperative mortality.The overall complication rates were 5.41%(2/37)and 21.62%(8/37)in the intervention and control groups,respectively.Tumor recurrence and overall survival rates were 2.70%and 97.30%in the study group and 13.51%and 91.89%in the control group,respectively.CONCLUSION Intestinal stenting relieved acute obstructions,reduced the number of emergency surgeries,and supported laparoscopic procedures while improving primary anastomosis rates,minimizing ostomy occurrence,surgical trauma,and complications,and accelerating recovery. 展开更多
关键词 Acute intestinal obstruction Intestinal stent Safety Laparoscopic surgery Emergency surgery Efficacy
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Direct comparison of simultaneous and sequential endoscopic metallic bilateral stenting in malignant hilar biliary obstruction 认领 引用
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作者 Thomas Guilmoteau Olivier Rouquette +3 位作者 Anthony Buisson Sébastien Cambier Armand Abergel Laurent Poincloux 《World Journal of Gastroenterology》 SCIE CAS 2025年第19期41-51,共11页
BACKGROUND Endoscopic bilateral biliary drainage is a first line palliative treatment for unresectable malignant hilar biliary obstruction(MHBO)but remains technically challenging.The emergence of self-expandable meta... BACKGROUND Endoscopic bilateral biliary drainage is a first line palliative treatment for unresectable malignant hilar biliary obstruction(MHBO)but remains technically challenging.The emergence of self-expandable metallic stents carried by an ultrathin(6 Fr or smaller)delivery system now permits simultaneous bilateral stent placement.To date,only a few studies have compared this new method with conventional sequential bilateral stenting.AIM To evaluate a possible superiority of simultaneous“side by side”(SBS)biliary drainage in unresectable MHBO.METHODS We identified 135 patients who benefited from bilateral drainage using uncovered self-expandable metallic stents between 2010 and 2023.Among them,62 benefited from simultaneous SBS bilateral drainage between 2017 and 2023,and 73 benefited from sequential bilateral drainage[38 using“stent in stent”(SIS)technique and 35 using SBS technique between 2010 and 2017].RESULTS Technical success was significantly increased in simultaneous drainage compared with sequential drainage(94%vs 75%,P=0.008).However,simultaneous SBS drainage and sequential SIS drainage had a similar technical success(94%vs 95%).We observed no differences regarding clinical success,procedure duration and recurrent biliary obstruction rate.Stent patency was shorter in the SIS group compared with the simultaneous group(103 days vs 144 days).Early adverse events were more frequent in the sequential group(31%vs 21%,P=0.205),with no differences regarding SIS or SBS technique.Technical failure was associated with a higher rate of infectious fatal adverse events(9.5%vs 1.7%,P=0.02).Reintervention after recurrent biliary obstruction seems to be more successful after using SBS rather than SIS techniques(83%vs 75%,P=0.53).CONCLUSION Simultaneous SBS metallic stent placement using an ultra-thin delivery system was technically easier and as efficient as sequential bilateral stenting in unresectable MHBO to achieve bilateral drainage.The SIS procedure remains a good option in unresectable MHBO. 展开更多
关键词 Malignant hilar biliary obstruction Endoscopic retrograde cholangiopancreatography Self expandable metallic stent Simultaneous drainage Side by side Stent in stent
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A Novel guide extension assisted stenting technique for coronary bifurcation lesions 认领 引用
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作者 Shams Y-Hassan Rodney de Palma 《World Journal of Cardiology》 2021年第6期155-162,共8页
A challenging technical scenario frequently encountered in a percutaneous coronary intervention of a coronary bifurcation lesion(CBL)is stent implantation of only the stenosed segment without compromising the other tw... A challenging technical scenario frequently encountered in a percutaneous coronary intervention of a coronary bifurcation lesion(CBL)is stent implantation of only the stenosed segment without compromising the other two normal segments in non-true bifurcation lesions.Another is precise stent implantation covering the side branch ostium without leaving excessive stent metal at the other two segments of a bifurcation lesion in complex true bifurcation lesions.The aim of this study was to describe a novel stenting technique for both non-true and true CBLs by using a guide extension catheter(GuideLiner).With the assistance of a guide extension catheter mounted on both the main and the side-branch guidewires and with its intubation down to the bifurcation carina,a stent can be implanted in the side branch segment or distal main segment of the bifurcation lesion appropriately without compromising the other two segments of the coronary bifurcation.Stent implantation is described in three bifurcation lesions in three cases and shown in detail with illustrative figures.The technique facilitates side-branch only stenting in side-branch mono-ostial(medina 0,0,1)CBL or only the distal main segment in distal mono-ostial(medina 0,1,0)CBL without compromising the other two remaining segments when using the onestent technique in non-true CBLs without leaving unnecessary excessive stent metal at the bifurcation site and when using a two-stent technique in complex true bifurcation lesions(tri-ostial or medina 1,1,1).Consequently,through optimizing stent deployment,the technique may have the potential to reduce the risk of subacute stent thrombosis and future in-stent restenosis.The most appropriate lesions suitable for the technique,and some other practical tips are also described. 展开更多
关键词 Coronary bifurcation lesion GuideLiner stenting Percutaneous coronary intervention One-or two-stenting technique Novel descriptive,intelligible and ordered
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Endoscopic luminal stenting:Current applications and future perspectives 认领 引用 被引量：2
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作者 Miltiadis Moutzoukis Konstantinos Argyriou +1 位作者 Andreas Kapsoritakis Dimitrios Christodoulou 《World Journal of Gastrointestinal Endoscopy》 2023年第4期195-215,共21页
Endoscopic luminal stenting(ELS)represents a minimally invasive option for the management of malignant obstruction along the gastrointestinal tract.Previous studies have shown that ELS can provide rapid relief of symp... Endoscopic luminal stenting(ELS)represents a minimally invasive option for the management of malignant obstruction along the gastrointestinal tract.Previous studies have shown that ELS can provide rapid relief of symptoms related to esophageal,gastric,small intestinal,colorectal,biliary,and pancreatic neoplastic strictures without compromising cancer patients’overall safety.As a result,in both palliative and neoadjuvant settings,ELS has largely surpassed radiotherapy and surgery as a first-line treatment modality.Following the abovementioned success,the indications for ELS have gradually expanded.To date,ELS is widely used in clinical practice by well-trained endoscopists in managing a wide variety of diseases and complications,such as relieving non-neoplastic obstructions,sealing iatrogenic and non-iatrogenic perforations,closing fistulae and treating post-sphincterotomy bleeding.The abovementioned development would not have been achieved without corresponding advances and innovations in stent technology.However,the technological landscape changes rapidly,making clinicians’adaptation to new technologies a real challenge.In our mini-review article,by systematically reviewing the relevant literature,we discuss current developments in ELS with regard to stent design,accessories,techniques,and applications,expanding the research basis that was set by previous studies and highlighting areas that need to be further investigated. 展开更多
关键词 Endoscopic luminal stenting Obstruction Stricture Stenting Leak Cancer Inflammatory bowel disease Bariatric surgery
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Outcome of stenting in biliary and pancreatic benign and malignant diseases:A comprehensive review 认领 引用 被引量：10
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作者 Benedetto Mangiavillano Nico Pagano +1 位作者 Todd H Baron Carmelo Luigiano 《World Journal of Gastroenterology》 SCIE CAS 2015年第30期9038-9054,共17页
Endoscopic stenting has become a widely method for the management of various malignant and benign pancreatico-biliary disorders. Biliary and pancreatic stents are devices made of plastic or metal used primarily to est... Endoscopic stenting has become a widely method for the management of various malignant and benign pancreatico-biliary disorders. Biliary and pancreatic stents are devices made of plastic or metal used primarily to establish patency of an obstructed bile or pancreatic duct and may also be used to treat biliary or pancreatic leaks,pancreatic fluid collections and to prevent post-endoscopic retrograde cholangiopancreatography pancreatitis. In this review,relevant literature search and expert opinions have been used to evaluate the outcome of stenting in biliary and pancreatic benign and malignant diseases. 展开更多
关键词 Endoscopic stenting Self-expandable metalstent Plastic stent Strictures Leaks Complications
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Effect of Preoperative Double-J Ureteral Stenting before Flexible Ureterorenoscopy on Stone-free Rates and Complications 认领 引用 被引量：10
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作者 Pei-de BAI Tao WANG +7 位作者 Hai-chao HUANG Zhun WU Xue-gang WANG Jia-xuan QIN Hui-qiang WANG Bin CHEN Meng-bo HU Jin-chun XING 《Current Medical Science》 SCIE CAS 2021年第1期140-144,共5页
The effect of preoperative Double-J(DJ)ureteral stenting before flexible ureterorenoscopy(FURS)in the treatment for urinary stones was evaluated.We retrospectively enrolled 306 consecutive patients who underwent FURS ... The effect of preoperative Double-J(DJ)ureteral stenting before flexible ureterorenoscopy(FURS)in the treatment for urinary stones was evaluated.We retrospectively enrolled 306 consecutive patients who underwent FURS from Jan.2014 to Dec.2017.All the patients were classified into two groups according to whether they had DJ ureteral stenting before FURS.Baseline characteristics(age,sex,stone location,stone size,surgical success rate,operation time,stone-free rate of the first day after surgery,stone-free rate of the first month after surgery,total complication rate)were compared using Chi-square test for categorical variables and Kruskal-Wallis test for continuous variables.In total,306 patients were included in this study.The group of DJ stenting before FURS included 203(66.3%)patients,and non-DJ stenting before FURS was observed in 103(33.7%)patients.The group of DJ stenting before FURS was significantly associated with a shorter operation time(53.8 vs.59.3 min,P<0.001),a higher stone-free rate of the first day after surgery(69.0%vs.51.5%,P=0.003).However,statistical significant differences were not found in the age,sex,stone location,stone size,surgical success rate,stone-free rate of the first month after surgery(89.2%vs.81.6%,P=0.065)and total complication rate(5.4%vs.9.7%,P=0.161)between the two groups.Preoperative DJ ureteral stenting before FURS could reduce the operation time and increase stone-free rate of the first day after surgery.However,it might not benefit the stone-free rate of the first month after surgery and reduce the complication rate.Preoperative DJ stenting should be not routinely performed. 展开更多
关键词 Double-J ureteral stenting flexible ureterorenoscopy stone-free rate complication rate
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Comparison of endoscopic stenting for malignant biliary obstruction: A single-center study 认领 引用 被引量：12
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作者 Ryuichi Yamamoto Masatomo Takahashi +4 位作者 Yasuyo Osafune Katsuya Chinen Shingo Kato Sumiko Nagoshi Koji Yakabi 《World Journal of Gastrointestinal Endoscopy》 2015年第9期889-894,共6页
AIM: To evaluate the efficacy and safety of single-step endoscopic placement of self-expandable metallic stents(SEMS) for treatment of obstructive jaundice.METHODS: A retrospective study was performed among 90 patient... AIM: To evaluate the efficacy and safety of single-step endoscopic placement of self-expandable metallic stents(SEMS) for treatment of obstructive jaundice.METHODS: A retrospective study was performed among 90 patients who underwent transpapillary biliary metallic stent placement for malignant biliary obstruction(MBO) between April 2005 and October 2012. The diagnosis of primary disease and MBO was based on abdominal ultrasound, computed tomography, magnetic resonance imaging, endoscopic ultrasound, endoscopic retrograde cholangiopancreatography with brush cytology, biopsy, and/or a combination of these modalities. The type of SEMS(covered or non-covered, 8 mm or 10 mm in diameter) was determined by the endoscopist. Ninety patients were divided into two groups: group 1(49 patients) who underwent a singlestep SEMS placement and group 2(41 patients) who underwent a two-step SEMS placement. The technical success rate, complication rate, stent patency, and patient survival rate were compared between the groups. In addition, to identify the clinical prognostic factors associated with patient survival, the following variables were evaluated in Cox-regression analysis: gender, age, etiology of MBO(pancreatic cancer or nonpancreatic cancer), clinical stage(Ⅳb; with distant metastases or Ⅳa >; without distant metastases), chemotherapy(with or without), patency of the stent, and the use of single-step or two-step SEMS. RESULTS: Immediate technical success was achieved in 93.9%(46/49) in group 1 and in 95.1%(39/41) in group 2, with no significant difference(P = 1.0). Similarly, there was no difference in the complication rates between the groups(group 1, 4.1% and group 2, 4.9%; P = 0.62). Stent failure was observed in 10 cases in group 1(20.4%) and in 16 cases in group 2(39.0%). The patency of stent and patient survival revealed no difference between the two groups with Kaplan-Meier analysis, with a mean patency of 111 ± 17 d in group 1 and 137 ± 19 d in group 2(P = 0.91), and a mean survival of 178 ± 35 d in group 1 and 222 ± 23 d in group 2(P = 0.57). On the contrary, the number of days of hospitalization associated with first-time SEMS placement in group 1 was shorter when compared with that number in group 2(28 vs 39 d; P (P = 0.0055), chemotherapy(P = 0.0048), and no patency of the stent(P = 0.011) were independent prognostic factors associated with patient survival.CONCLUSION: Our results showed that single-step endoscopic metal stent placement was safe and effective for treating obstructive jaundice secondary to various inoperable malignancies. 展开更多
关键词 Endoscopic stenting Single-step Malignantbiliary obstruction Self-expandable metallic stents Twostep
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Duodenal stenting for malignant gastric outlet obstruction:Prospective study 认领 引用 被引量：7
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作者 Eduardo Guimaräes Hourneaux Moura Flávio Coelho Ferreira +3 位作者 Spencer Cheng Diogo Turiani Hourneaux Moura Paulo Sakai Bruno Zilberstain 《World Journal of Gastroenterology》 SCIE CAS CSCD 2012年第9期938-943,共6页
AIM： To evaluate the results of duodenal stenting for palliation of gastroduodenal malignant obstruction by using a gastric outlet obstruction score （GOOS）.
关键词 Enteral stenting Gastric outlet obstructionscoring system Gastroduodenal malignancy Self-expan-dable metal stent
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Complications and survival in patients undergoing colonic stenting for malignant obstruction 认领 引用 被引量：5
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作者 Majid A Almadi Nahla Azzam +3 位作者 Othman Alharbi Alabbas H Mohammed Nazia Sadaf Abdulrahman M Aljebreen 《World Journal of Gastroenterology》 SCIE CAS 2013年第41期7138-7145,共8页
AIM:To investigate whether predicting patients that might be at a higher risk for complications might serve to improve the selection of patients undergoing colonic stenting.METHODS:A retrospective review of consecutiv... AIM:To investigate whether predicting patients that might be at a higher risk for complications might serve to improve the selection of patients undergoing colonic stenting.METHODS:A retrospective review of consecutive patients who underwent an attempted self-expandable metal stent(SEMS)insertion for malignant colonic obstruction between November 2006 and March 2013.All patients were either referred for preoperative colonic decompression with the intent of a single surgical procedure,or for palliation of the malignant colorectal obstruction for unresectable cancer.Fisher’s test orχ2test was performed on categorical variables,and the t test for continuous variables.Univariable and multivariable logistic regression were used to examine the association between independent variables and the presence of complications from SEMS insertion.RESULTS:SEMS insertion was attempted in 73 patients.Males comprised 55.71%and the mean age was 67.41±12.41 years.Of these,65.15%underwent subsequent surgery,while 34.85%received SEMS as palliation for advanced disease.Extracolonic tumors were only4.76%.The majority of patients had stageⅣdisease(63.83%),while the remainder had stageⅢ(36.17%).SEMS were successfully inserted in 93.85%(95%CI:87.85%-99.85%).Perforations occurred in 4.10%,SEMS migration in 8.21%,and stent re-occlusion from ingrowth occurred in 2.74%of patients.The mean duration of follow up for the patients was 13.52±17.48 mo(range 0-73 mo).None of the variables:age,sex,time between the onset of symptoms to SEMS insertion,time between SEMS insertion and surgery,length of the stenosis,location of the stenosis,albumin level,or receiving neoadjuvant chemotherapy,could predict the development of complications from either SEMS insertion nor prolonged survival.CONCLUSION:None of the variables could predict the development of complications or survival.Further studies are required to identify patients who would benefit the most from SEMS. 展开更多
关键词 Colonic obstruction Colorectal cancer Palliative interventions Self-expanding metal stent Colonic stents Enteric stenting Emergency surgery Complications Endoscopy
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Mechanical lithotripsy and/or stenting in management of difficult common bile duct stones 认领 引用 被引量：7
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作者 Adem Akcakaya Orhan Veli Ozkan +4 位作者 Gurhan Bas Atilla Karakelleoglu Orhan Kocaman Ismail Okan Mustafa Sahin 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS 2009年第5期524-528,共5页
BACKGROUND:Mechanical lithotripsy and/or stent insertion is the alternative therapeutic approach in difficult endoscopic retrograde cholangiopancreatography (ERCP)case.This study was designed to investigate the approp... BACKGROUND:Mechanical lithotripsy and/or stent insertion is the alternative therapeutic approach in difficult endoscopic retrograde cholangiopancreatography (ERCP)case.This study was designed to investigate the appropriate treatment for extraction of bile duct stones in difficult cases of ERCP. METHODS:Between 2000 and 2008,744 ERCP procedures were performed in 592 patients with choledocholithiasis in our endoscopy unit.The demographic features,and clinical and laboratory findings were collected from a prospectively held database.Bile duct calculi were extracted by basket and/or balloon catheter following ERCP and sphincterotomy.Patients with retained stones were regarded as difficult cases.These patients were treated with mechanical lithotripsy and those with incomplete clearance of stones underwent stent placement. RESULTS:Two hundred and forty-five patients(41%) were male and 347(59%)were female with a mean age of 58 years(range 19-95 years).Stones were impacted in 27 patients(5%).Stone extraction was performed by basket and/or balloon catheter in 610 ERCP procedures,and lithotripsy was performed in 70 ERCP procedures.Forty- four patients underwent stent insertion,and 20 underwent stent replacement.Morbidity occurred in 39 patients (5%),with no mortality associated with the procedure.Hemorrhage occurred in 9 patients and basket impaction in 4.Mild pancreatitis and cholangitis developed in 12 and 11 patients,respectively. CONCLUSION:Difficult cases of bile duct stones can be treated successfully with lithotripsy,and a stent should be applied when the common bile duct cannot be cleared completely. 展开更多
关键词 common bile duct stone endoscopic retrograde cholangiopancreatography stone extraction mechanical lithotripsy stenting
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Need for pancreatic stenting after sphincterotomy in patients with difficult cannulation 认领 引用 被引量：7
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作者 Kazunari Nakahara Chiaki Okuse +4 位作者 Keigo Suetani Yosuke Michikawa Shinjiro Kobayashi Takehito Otsubo Fumio Itoh 《World Journal of Gastroenterology》 SCIE CAS 2014年第26期8617-8623,共7页
AIM: To investigate the need for pancreatic stenting after endoscopic sphincterotomy (EST) in patients with difficult biliary cannulation.
关键词 Pancreatic stenting Pancreatic guidewire placement Post-endoscopic retrograde cholangiopancreatography pancreatitis Endoscopic sphincterotomy Endoscopic retrograde cholangiopancreatography
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Percutaneous trans-hepatic bilateral biliary stenting in Bismuth Ⅳ malignant obstruction 认领 引用 被引量：4
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作者 Dimitrios Karnabatidis Stavros Spiliopoulos +3 位作者 Paraskevi Katsakiori Odissefs Romanos Konstantinos Katsanos Dimitrios Siablis 《World Journal of Hepatology》 2013年第3期114-119,共6页
AIM: To investigate the clinical efficiency of percutaneous trans-hepatic bilateral biliary metallic stenting for the management of Bismuth Ⅳ malignant obstructive disease. METHODS: Our hospital's database was se... AIM: To investigate the clinical efficiency of percutaneous trans-hepatic bilateral biliary metallic stenting for the management of Bismuth Ⅳ malignant obstructive disease. METHODS: Our hospital's database was searched for all patients suffering from the inoperable malignant biliary obstruction Bismuth Ⅳ, and treated with percutaneous bilateral trans-hepatic placement of selfexpandable nitinol stents. The indication for percutaneous stenting was an inoperable, malignant, symptomatic, biliary obstruction. An un-correctable coagulation disorder was the only absolute contra-indication for treatment. Bismuth grading was performed using magnetic resonance cholangiopancreatography. Computed tomography evaluation of the lesion and the dilatation status of the biliary tree was always performed prior to the procedure. All procedures were performed under conscious sedation. A single trans-hepatic track technique was preferred (T-configuration stenting) and a second, contra-lateral trans-hepatic track (Y-configuration stenting) was used only in cases of inability to access the contra-lateral lobe using a single track technique. The study's primary endpoints were clinical success, defined as a decrease in bilirubin levels within 10 d and patient survival rates. Secondary endpoints included peri-procedural complications, primary and secondary patency rates. RESULTS: A total of 35 patients (18 female, 51.4%) with a mean age 69 ± 13 years (range 33-88) were included in the study. The procedures were performed between March 2000 and June 2008 and mean time follow-up was 13.5 ± 22.0 mo (range 0-96). The underlying malignant disease was cholangiocarcinoma (n = 10), hepatocellular carcinoma (n = 9), pancreatic carcinoma (n = 5), gastric cancer (n = 2), bile duct tumor (n = 2), colorectal cancer (n = 2), gallbladder carcinoma (n = 2), lung cancer (n = 1), breast cancer (n = 1) or non-Hodgkin lymphoma (n = 1). In all cases, various self-expandable bare metal stents with diameters ranging from 7 to 10 mm were used. Stents were placed in Y-configuration in 24/35 cases (68.6%) using two stents in 12/24 patients and three stents in 12/24 cases (50%). A T-configuration stent placement was performed in 11/35 patients (31.4%), using two stents in 4/11 cases (36.4%) and three stents in 7/11 cases (63.6%). Follow-up was available in all patients (35/35). Patient survival ranged from 0 to 1763 d and the mean survival time was 168 d. Clinical success rate was 77.1% (27/35 cases), and peri-procedural mortality rate was 5.7% (2/35 patients). Biliary reobstruction due to stent occlusion occurred in 25.7% of the cases (9/35 patients), while in 7/11 (63.6%) one additional percutaneous re-intervention due to stent occlusion resulting in clinical relapse of symptomatology was successfully performed. In the remaining 4/11 patients (36.4%) more than 1 additional reintervention was performed. The median decrease of total serum bilirubin was 60.5% and occurred in 81.8% of the cases (27/33 patients). The median primary and secondary patency was 105 (range 0-719) and 181 d (range 5-1763), respectively. According to the KaplanMeyer survival analysis, the estimated survival rate was 73.5%, 47.1% and 26.1% at 1, 6 and 12 mo respectively, while the 8-year survival rate was 4.9%. Major and minor complication rates were 5.7% (2/35 patients) and 17.1% (6/35 patients), respectively. CONCLUSION: Percutaneous bilateral biliary stenting is a safe and clinically effective palliative approach in patients suffering from Bismuth Ⅳ malignant obstruction. 展开更多
关键词 Bismuth Ⅳ Malignant biliary obstruction Percutaneous bilateral stenting Nitinol stents Palliative treatment Fluoroscopically-guided
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Ultrasound-guided carotid angioplasty and stenting in a patient with iodinated contrast allergy:A case report 认领 引用 被引量：1
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作者 Le Li Zi-Yan Wang Bo Liu 《World Journal of Clinical Cases》 SCIE 2023年第25期5926-5933,共8页
BACKGROUND Ischemic stroke is an entity with high incidence,morbidity,and mortality rates.Carotid artery stenosis is an important and independent risk factor for ischemic stroke.The three current approaches for treati... BACKGROUND Ischemic stroke is an entity with high incidence,morbidity,and mortality rates.Carotid artery stenosis is an important and independent risk factor for ischemic stroke.The three current approaches for treating carotid artery stenosis are drug treatment,carotid endarterectomy(CEA),carotid angioplasty and stenting(CAS).The approach is chosen based on the degree of stenosis.CEA or CAS could have been chosen for the current patient,who had severe carotid stenosis and an iodinated contrast allergy.After thoroughly communicating with the patient,the patient chose CAS for treatment.Therefore,we performed ultrasound-guided CAS to avoid the use of iodinated contrast.CASE SUMMARY The main symptoms of the patient were numbness and weakness of the left limb.Computed tomography angiography of the head and neck at another hospital indicated multiple sites of stenosis in the arteries of the head and neck.The patient requested CAS for treatment but was allergic to iodinated contrast media.Thus,routine digital subtraction angiography(DSA)with iodinated contrast could not be used for the procedure.The diagnosis of this patient was as follows:(1)Right parietal lobe cerebral infarction;(2)multiple sites of stenosis in the arteries of the head and neck(severe stenosis of the right internal carotid artery,severe stenosis of the right subclavian artery);(3)right subclavian steal syndrome;and(4)hypertension(stage 3,high risk).The interventions included routine treatment for cerebral infarction,oral administration of clopidogrel(75 mg qd)and aspirin(100 mg qd),ultrasound-guided CAS,and postoperative follow-up.Postoperative color Doppler ultrasound and cerebrovascular magnetic resonance angiography of the carotid artery showed good vascular recovery,and the postoperative follow-up indicated a good prognosis.CONCLUSION This case study suggests that ultrasound-guided endovascular treatment is a potential option for patients with contraindications to the iodinated contrast agents used in DSA-guided surgery,although excellent surgical operating skills are needed. 展开更多
关键词 Iodinated contrast allergy Ultrasound-guided Gadolinium-based contrast agent Carotid angioplasty and stenting Subclavian artery angioplasty and stenting Digital subtraction angiography Case report
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Concomitant coronary and renal revascularization improves left ventricular hypertrophy more than coronary stenting alone in patients with ischemic heart and renal disease 认领 引用 被引量：4
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作者 Hao-jian DONG Cheng HUANG +5 位作者 De-mou LUO Jing-guang YE Jun-qing YANG Guang LI Jian-fang LUO Ying-ling ZHOU 《Journal of Zhejiang University-SCIENCE B》 SCIE CAS CSCD 2016年第1期67-75,共9页
Percutaneous transluminal renal artery stenting （PTRAS） has been proved to have no more benefit than medication alone in treating atherosclerotic renal artery stenosis （ARAS）. Whether PTRAS could improve left ven-... Percutaneous transluminal renal artery stenting （PTRAS） has been proved to have no more benefit than medication alone in treating atherosclerotic renal artery stenosis （ARAS）. Whether PTRAS could improve left ven- tricular hypertrophy （LVH） and reduce adverse events when based on percutaneous coronary intervention （PCI） for patients with coronary artery disease （CAD） and ARAS is still unclear. A retrospective study was conducted, which explored the effect of concomitant PCI and PTRAS versus PCI alone for patients with CAD and ARAS complicated by heart failure with preserved ejection fraction （HFpEF）. A total of 228 patients meeting inclusion criteria were divided into two groups： （1） the HFpEF-I group, with PCI and PTRAS; （2） the HFpEF-II group, with PCI alone. Both groups had a two-year follow-up. The left ventricular mass index （LVMI） and other clinical characteristics were compared between groups. During the follow-up period, a substantial decrease in systolic blood pressure （SBP） was observed in the HFpEF-I group, but not in the HFpEF-II group. There was marked decrease in LVMI in both groups, but the HFpEF-I group showed a greater decrease than the HFpEF-II group. Regression analysis demonstrated that PTRAS was significantly associated with LVMI reduction and fewer adverse events after adjusting for other factors. In HFpEF patients with both CAD and ARAS, concomitant PCI and PTRAS can improve LVH and decrease the incidence of adverse events more than PCI alone. This study highlights the beneficial effect of ARAS revascularization, as a new and more aggressive revascularization strategy for such high-risk patients. 展开更多
关键词 Coronary artery disease （CAD） Heart failure with preserved ejection fraction （HFpEF） Percutaneoustransluminal renal artery stenting （PTRAS） Renal artery stenosis
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Intravascular ultrasonography assisted carotid artery stenting for treatment of carotid stenosis: Two case reports 认领 引用 被引量：3
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作者 Peng-Cheng Fu Jing-Yi Wang +6 位作者 Ying Su Yu-Qi Liao Shao-Ling Li Ge-Lin Xu Yan-Jiao Huang Ming-Hua Hu Li-Ming Cao 《World Journal of Clinical Cases》 SCIE 2023年第29期7127-7135,共9页
BACKGROUND Digital subtraction angiography(DSA),the gold standard of cerebrovascular disease diagnosis,is limited in its diagnostic ability to evaluate arterial diameter.Intravascular ultrasonography(IVUS)has advantag... BACKGROUND Digital subtraction angiography(DSA),the gold standard of cerebrovascular disease diagnosis,is limited in its diagnostic ability to evaluate arterial diameter.Intravascular ultrasonography(IVUS)has advantages in assessing stenosis and plaque nature and improves the evaluation and effectiveness of carotid artery sten-ting(CAS).CASE SUMMARY Case 1:A 65-year-old man presented with a five-year history of bilateral lower limb weakness due to stroke.Physical examination showed decreased strength(5-/5)in both lower limbs.Carotid artery ultrasound,magnetic resonance angiography,and computed tomography angiography(CTA)showed a right proximal internal carotid artery(ICA)stenosis(70%-99%),acute cerebral infarction,and severe right ICA stenosis,respectively.We performed IVUS-assisted CAS to measure the stenosis and detected a low-risk plaque at the site of stenosis prior to stent implantation.Post-stent balloon dilatation was performed and postoperative IVUS demonstrated successful expansion and adherence.CTA six months postoperatively showed no significant increase in in-stent stenosis.Case 2:A 36-year-old man was admitted with a right common carotid artery(CCA)dissection detected by ultrasound.Physical examination showed no positive neurological signs.Carotid ultrasound and CTA showed lumen dilation in the proximal CCA with an intima-like structure and bulging in the proximal segment of the right CCA with strip-like low-density shadow(dissection or carotid web).IVUS-assisted DSA confirmed right CCA dissection.CAS was performed and intraoperative IVUS suggested a large residual false lumen.Post-stent balloon dilatation was performed reducing the false lumen.DSA three months postoperatively indicated good stent expansion with mild stenosis.CONCLUSION IVUS aids decision-making during CAS by accurately assessing carotid artery wall lesions and plaque nature preoperatively,dissection and stenosis morphology intraoperatively,and visualizing and confirming CAS postoperatively. 展开更多
关键词 Intravascular ultrasonography Carotid artery stenting Carotid stenosis Arteriosclerotic stenosis Carotid artery dissection Case report
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