抗反流胆管支架的研究进展

内镜逆行胰胆管造影术和支架置入术已逐渐成为远端恶性胆道梗阻患者的标准姑息治疗方式.但是随着各类材质支架的置入,废弃了Oddi括约肌的功能,改变了胆道正常解剖结构,致使十二指肠内容物易反流入胆管,患者发生胆管炎的概率明显升高,严重影响生活质量.为了减少胆管反流等相关不良事件的出现,抗反流支架应运而生.其大部分是通过在支架...

Research progress of anti-reflux biliary stents

Endoscopic retrograde cholangiopancreatography with stent implantation have gradually become the standard palliative care for patients with distal malignant biliary obstruction. Nevertheless, the function of the sphincter of Oddi is eliminated and the normal anatomical structure of the biliary tract is changed with the placement of stents of various materials. As a result, the duodenal contents will likely flow back into the bile duct, leading to a significantly increased probability of cholangitis in patients and seriously affecting the patients'' quality of life. In order to reduce the occurrence of associated adverse events such as bile duct reflux, anti-reflux stents have appeared. Most of them are designed by adding an anti-reflux valve at the end of the stent to function as an anti-reflux barrier. They can be categorized into anti-reflux plastic stents and anti-reflux metal stents according to the material, and also can be named by the shape of the anti-reflux valve such as the windsock anti-reflux stents, funnel anti-reflux stents and duckbill anti-reflux stents. A number of clinical studies demonstrated that most anti-reflux stents can not only reduce the occurrence of cholangitis, but also prolong the average patency time of the stent, with favorable clinical results. However, due to differences in the material and design of different types of stents, problems such as stent clogging and stent displacement still require to be further resolved. Here, the authors address the research progress and clinical application of anti-reflux biliary stents with different materials and structures by review of the relevant literature.