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英文誌(2004-)

Journal of Medical Ultrasonics

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2016 - Vol.43

Vol.43 No.Supplement

特別プログラム 消化器
シンポジウム 消化器 Joint(JSUM・AFSUMB・ACUCI Joint Session)(English) 消化器疾患の診断と治療におけるEUSの役割

(S323)

新型専用ステントを用いた超音波内視鏡下膵管ドレナージにおける有用性と安全性の検討

Usefulness of the newly designed plastic stent for EUS-guided pancreatic duct drainage

土屋 貴愛, 糸井 隆夫, 森安 史典

Takayoshi TSUCHIYA, Takao ITOI, Fuminori MORIYASU

東京医科大学臨床医学系消化器内科学分野

Department of Gastroenterology and Hepatology, Tokyo Medical University

キーワード :

Background and Aims: Endoscopic ultrasonography(EUS)-guided pancreatic interventions have gained increasing attention. Acute recurrent pancreatitis can occur due to pancreatic duct obstruction from any cause. Recently, EUS-guided pancreatic duct stent placement has been used to treat such patients when traditional ERCP fails or is not possible due to post-surgical anatomy. In these previous reports and case series the mean technical success rate was only about 80%.Furthermore, adverse events such as pancreatic duct leaks, stent migration, and pancreatitis commonly occurred. Thus, we developed a new single pigtail plastic stent designed for EUS-guided pancreatic duct drainage(EUS-PD)and used as first-line. The aim of this study is to retrospectively evaluate the feasibility and efficacy of newly designed plastic stent.
【Methods】
Twenty-two patients with acute recurrent pancreatitis due to main pancreatic duct stricture or stenotic pancreatojejunostomy underwent EUS-PD. EUS-PD were performed using a 19-gauge or 22-gauge fine-needle. After tract dilation, new tapered tip and fourfold-flanged single pigtail plastic stent(7Fr, total length: 20-cm, effective length: 15-cm, flanges: 4 with apertures, side holes: total 12 holes, distal straight site, 4 holes and pigtail site, 8 holes)was placed.
【Results】
New plastic stent was placed successfully without procedural complication in all cases(22/22,100%). Treatment success rate was 100%(22/22). Self-limited abdominal pain was observed in 3 patients, bleeding in 1 patient 1 day postoperatively(IVR was needed), and mild pancreatitis in 1 patient, but there were no stent migration.
【Conclusions】
A newly dedicated plastic stent which appears to be feasible and effective for EUS-PD.