经肝胃造瘘胃肠道支架成形术

目的探讨病情复杂的胃、十二指肠梗阻的支架成形术的方法及疗效。方法总结分析经口途径较难处理的胃、十二指肠支架成形术病例4例,其中2例Roux-en-Y吻合术后输入段十二指肠恶性梗阻并继发胆道梗阻的患者经肝途径置入支架;1例幽门区恶性狭窄和1例十二指肠降部恶性狭窄患者分别经胃造瘘置入支架。结果所有支架释放成功,患者均在术后第3天开始进流质,无消化道出血等并发症。随访期内均无支架移位及再狭窄。结论掌握技巧,肠道支架成形术在复杂性胃、十二指肠梗阻的治疗是可行的。

Gastrointestinal stenting:transhepatic and gastrostomy pathways

Objective To evaluate the clinical efficacy of three different ways to implant metallic stents for complex gastroduodenal obstruction.Materials Two cases of duodenal afferent loop malignant obstruction stenting accompanied by secordany biliary obsturctions after Roux-en-Y anastomosis were treated by transhepatic way of stenting.The other two cases included 1 pyloric and 1 duodenal obstructions treated by stent-placement through gastrostomy for the failure of peroral approach. Results Four wallstents were implanted successfully.All the patients were recovered with liquid food intake.Neither restenosis nor displacement occurred during the period of follow-up. Conclusions Reasonable pathway stent application,complex gastrointestinal obstruction could be treated properly.