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目的 探讨Separate支架置入术在姑息性治疗不能手术的胃肠道恶性梗阻的可行性和有效性。方法 34例患者采用经口置入Separate支架治疗不能手术的恶性胃十二指肠梗阻。梗阻的原因分别是胃癌 1 1例、胰腺癌 1 2例、转移性肿瘤 3例、胆道肿瘤 6例和十二指肠癌 2例。透视下分别将Separate支架的外层带膜支架和内层裸支架同轴重叠释放在狭窄病变处。结果 技术成功率为 97% ,未发生严重并发症。 33例患者胃肠道梗阻症状缓解或消失 ,在Separate支架置入后 ,患者进食能力评分平均从 3.8提高到 1 .2。随访期间未发现支架移位和肿瘤内生性生长等并发症 ,1例患者由于肿瘤浸润致支架近端梗阻复发 ,置入第 2枚支架。结论 经口途径置入Separate支架姑息性治疗不能手术的胃十二指肠恶性梗阻是可行的和有效的
Objective To investigate the feasibility and effectiveness of separate stenting in the treatment of inoperable gastrointestinal malignant obstruction. Methods 34 cases of patients with malignant gastroduodenal obstruction inoperable with oral stent placement. The causes of obstruction were 11 cases of gastric cancer, 12 cases of pancreatic cancer, 3 cases of metastatic tumors, 6 cases of biliary tumors and 2 cases of duodenal cancer. Under the fluoroscopy, the outer scaffolds of the separate scaffolds and the bare scaffolds of the inner scaffold are overlapped and released in the narrow lesions respectively. Results The technical success rate was 97% without serious complications. In 33 patients, the symptoms of gastrointestinal obstruction were relieved or disappeared. After the separate stent was inserted, the patients’ ability to eat improved from 3.8 to 1.2 on average. During the follow-up period, no complications such as stent dislocation and tumor endogenous growth were found. One patient had recurrence of proximal stent-proximal obstruction due to tumor invasion, and the second stent was placed. Conclusions Palliative treatment of inoperable gastroduodenal malignant obstruction by separate stent placement via oral route is feasible and effective