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11.
Biliary stent causing colovaginal fistula: case report. 总被引:2,自引:0,他引:2
Anna-Maria Blake Narinder Monga Ernest M Dunn 《JSLS, Journal of the Society of Laparoendoscopic Surgeons》2004,8(1):73-75
OBJECTIVES: Perforation of the bowel during placement of a biliary stent is a known complication of this procedure. We report the endoluminal loss of a biliary stent during routine stent extraction that ultimately led to a chronic colovaginal fistula. This case emphasizes the need for evaluation of fecal passage of stents in patients with a known dislodged prosthesis. CASE REPORT: A 65-year-old white female underwent biliary stent placement for an episode of choledocholithiasis. The stent was lost in the duodenum during routine extraction. The patient was managed expectantly. She denied ever passing this stent via the rectum and began to develop symptoms of colovaginal fistula. Evaluation found a retained biliary stent in the sigmoid colon and a fistula into the vagina. The patient underwent elective low anterior resection and colovaginal fistula repair. DISCUSSION: Reports exist of migration of stents that lead to acute colonic perforation and the need for emergent surgery. For this reason, it has been suggested that dropped or migrated stents be purposefully retrieved. However, if the option of expectant observation is used, it is important to clearly document the fecal passage of these stents and be prepared to retrieve these objects if they have a prolonged bowel transit time. 相似文献
12.
Self-expandable metallic stent for unresectable malignant strictures in the esophagus and cardia 总被引:2,自引:0,他引:2
Shigeru Lee Harushi Osugi Taigo Tokuhara Masashi Takemura Masahiro Kaneko Yoshinori Tanaka Yushi Fujiwara Satoshi Nishizawa Hiroshi Iwasaki Shigefumi Suehiro 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2005,53(9):470-476
Objective Self-expandable metallic stent (EMS) placement has been the first choice for dysphagia because of the certainty over its safety,
low invasiveness, and immediate efficacy. However, there still remain some problems in relation to the EMS placement site
and anticancer therapies before and after EMS placement. Methods: Consecutive 78 patients in whom EMS was placed due to the unresectable malignant stricture in the esophagus or cardia from
July 1995 to August 2003 in our department were studied. Results: Gastroesophageal reflux was found in 5 of 8 patients after placement of conventional EMS for the stricture in the gastroesophageal
junction. Meanwhile, acid and bile reflux into the esophagus were not detected by pH and bilirubin monitoring, respectively,
in 6 patients after placement of the EMS with an anti-reflux mechanism for the stricture in the gastroesophageal junction.
The median survival period of all patients after EMS placement was 123 days. The median survival period of 7 patients with
radiotherapy only after EMS placement was 138 days and that of 17 patients with radiotherapy before EMS placement was 60 days,
which was shorter than that of the former (p<0.05). On the other hand, the median survival period after hospital admission
due to dysphagia of these 7 patients was longer than that of 17 patients with radiotherapy only before EMS placement, although,
the difference was not significant. Conclusion: EMS with an antireflux mechanism is not commercially available in Japan and approval is urgently required. The indication
of radiotherapy associated with EMS placement is to be studied further. 相似文献
13.
Kazushi Kishi Taizo Takeuchi Tetsuo Sonomura Masashi Kimura Keisuke Kita Morio Sato Masaki Terada 《Cardiovascular and interventional radiology》1997,20(1):63-66
In order to treat fistulated esophageal cancer using a flexible stent, a covered flexible stent was constructed by wrapping
a nitinol stent with a thin sheet of Gore-Tex, preserving the stents original advantages of flexibility and a low-profile
introducer system. This stent was used to perform standard radiotherapy in a case of fistulated esophageal cancer. 相似文献
14.
Self-expanding mesh stent for endoscopic palliation of rectal obstructing tumors: a preliminary report 总被引:2,自引:0,他引:2
Summary The endoscopic insertion of self-expanding mesh stents in four patients affected by obstructing rectal malignant tumors is reported. The preliminary experience shows that, in the short term, normal defecation was achieved, with no complications. Longer follow-up is necessary to evaluate the duration and the quality of the palliative effect. 相似文献
15.
Results of the routine use of a modified endoprosthesis to drain the common bile duct after laparoscopic choledochotomy 总被引:6,自引:1,他引:5
A. L. DePaula K. Hashiba M. Bafutto C. Machado A. Ferrari M. M. Machado 《Surgical endoscopy》1998,12(7):933-935
Background: One hundred eighty-one patients were submitted to laparoscopic common bile duct exploration.
Methods: A transcystic approach was used in 147 patients, choledochotomy in 14, and both in 20. The indications to perform a choledochotomy
included stones larger than 20 mm, stones proximal to the cystic duct entrance, and cases in which the transcystic duct approach
proved impossible or unsuccessful.
Results: The common bile duct was drained by a T-tube in four patients, by laparoscopic sphincterotomy in one, by laparoscopic choledochoduodenostomy
in one, and by a 10 Fr endoprosthesis in 28. The stent placement was technically feasible in all patients but one. The biliary
drainage was adequate. Mean hospital stay was 2.1 days. Complication was limited to one umbilical infection and one self-limited
biliary leak.
Conclusions: The procedure proved to be technically simple, safe, and efficient, and resulted in a low morbidity rate and short hospital
stay.
Received: 29 March 1996/Accepted: 12 June 1996 相似文献
16.
Thomas Lanspa Dennis J Esterbrooks Mark A Williams 《Catheterization and cardiovascular interventions》2005,64(2):223-226
Stenting of the carotid artery is usually performed either to prevent an acute neurologic event or to treat episodes of recurrent transient ischemic attacks. Occasionally, it may be performed for other indications. We describe the case of a patient with prior coronary artery bypass grafting using a left internal mammary arterial graft, in addition to left carotid artery to left subclavian artery bypass for symptomatic left subclavian stenosis, who subsequently underwent left common carotid artery stenting to relieve anginal symptoms. 相似文献
17.
目的 评价直接置入药物洗脱支架 (CYPHERTM,codis)在A或B1 型病变的冠心病患者治疗中的安全性、可行性。方法 6 2例接受CYPHERTM 支架直接置入的患者 (直接支架组 )和一般情况匹配的 5 1例球囊扩张后行冠脉支架术的患者 (常规支架组 ) ,比较两组的一般情况 ,冠脉造影及介入治疗即刻和临床随访结果。结果 直接支架组介入操作时间明显短于常规支架组 [(17.2± 8.6 )比 (2 6 .3± 7.1)min ,P <0 .0 1],直接支架组平均扩张压明显高于常规支架组 [(14± 3)比 (12± 1.9)atm ,P<0 .0 1],两组无一例发生介入治疗相关的严重心脏事件。随访期间两组严重心脏不良事件发生率无显著差异。结论 A或B1 型病变的冠心病患者CYPHERTM 支架直接置入术可缩短介入操作时间 ,即刻效果、并发症及中期临床随访与常规支架组差异无显著性意义 相似文献
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