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Abstract：
UNASSIGNED: Self-expandable metal stents are used for malignant duodenal obstruction. Outcomes between stents placed above and below the papilla of Vater differ, and no study has investigated these differences. We evaluated the efficacy and adverse events of stent placement in these two locations and reported our experience with self-expandable metal stent placement in patients.
UNASSIGNED: We retrospectively analyzed the data of patients with unresectable metastatic cancers (n = 101), who underwent successful duodenal self-expandable metal stent placement between 2008 and 2018. Patients were divided into above and below the papilla of Vater groups. Patient demographics, technical and clinical outcomes, post-procedural morbidity, and stent patency were analyzed.
UNASSIGNED: Overall, 71 and 30 patients had intestinal obstruction above (including the papilla itself) and below the papilla of Vater and underwent successful stenting. Common bile duct obstruction was more common in the above-papilla group. Procedure time was similar between the groups, if an appropriate endoscope could facilitate stent placement in the below-papilla group. Both groups achieved symptomatic relief. Median stent patency duration was not significantly different between the groups; three patients had severe gastrointestinal bleeding due to postoperative vascular-enteric fistula.
UNASSIGNED: Self-expandable metal stents can effectively relieve symptoms of duodenal obstructions located above and below the papilla of Vater. Duodenoscopes could facilitate stent placement if the obstruction is located below the papilla of Vater; if gastrointestinal bleeding occurs postoperatively, the possibility of vascular-enteric fistula formation should be considered.
UNASSIGNED: We retrospectively analyzed the data of patients with unresectable metastatic cancers (n = 101), who underwent successful duodenal self-expandable metal stent placement between 2008 and 2018. Patients were divided into above and below the papilla of Vater groups. Patient demographics, technical and clinical outcomes, post-procedural morbidity, and stent patency were analyzed.
UNASSIGNED: Overall, 71 and 30 patients had intestinal obstruction above (including the papilla itself) and below the papilla of Vater and underwent successful stenting. Common bile duct obstruction was more common in the above-papilla group. Procedure time was similar between the groups, if an appropriate endoscope could facilitate stent placement in the below-papilla group. Both groups achieved symptomatic relief. Median stent patency duration was not significantly different between the groups; three patients had severe gastrointestinal bleeding due to postoperative vascular-enteric fistula.
UNASSIGNED: Self-expandable metal stents can effectively relieve symptoms of duodenal obstructions located above and below the papilla of Vater. Duodenoscopes could facilitate stent placement if the obstruction is located below the papilla of Vater; if gastrointestinal bleeding occurs postoperatively, the possibility of vascular-enteric fistula formation should be considered.
摘要：
■自膨胀金属支架用于恶性十二指肠梗阻。放置在Vater乳头上方和下方的支架之间的结果不同，没有研究调查这些差异。我们评估了在这两个位置放置支架的疗效和不良事件，并报告了我们在患者中放置自膨式金属支架的经验。
■我们回顾性分析了不可切除的转移性癌症患者的数据（n=101），他们在2008年至2018年期间成功进行了十二指肠自膨式金属支架置入术.将患者分为Vater乳头上方和下方组。患者人口统计学，技术和临床结果，术后发病率，并对支架通畅性进行分析。
■总的来说，71和30例患者在Vater乳头上方（包括乳头本身）和下方有肠梗阻，并成功置入支架。胆总管阻塞多见于乳头以上组。两组之间的手术时间相似，如果适当的内窥镜可以促进乳头以下组的支架放置。两组均达到症状缓解。两组之间的中位支架通畅时间没有显着差异；三名患者由于术后血管肠瘘而发生严重的消化道出血。
■自膨胀金属支架可有效缓解位于Vater乳头上方和下方的十二指肠阻塞的症状。如果梗阻位于Vater乳头下方，十二指肠镜可以促进支架放置；如果术后发生消化道出血，应考虑血管-肠瘘形成的可能性.
■我们回顾性分析了不可切除的转移性癌症患者的数据（n=101），他们在2008年至2018年期间成功进行了十二指肠自膨式金属支架置入术.将患者分为Vater乳头上方和下方组。患者人口统计学，技术和临床结果，术后发病率，并对支架通畅性进行分析。
■总的来说，71和30例患者在Vater乳头上方（包括乳头本身）和下方有肠梗阻，并成功置入支架。胆总管阻塞多见于乳头以上组。两组之间的手术时间相似，如果适当的内窥镜可以促进乳头以下组的支架放置。两组均达到症状缓解。两组之间的中位支架通畅时间没有显着差异；三名患者由于术后血管肠瘘而发生严重的消化道出血。
■自膨胀金属支架可有效缓解位于Vater乳头上方和下方的十二指肠阻塞的症状。如果梗阻位于Vater乳头下方，十二指肠镜可以促进支架放置；如果术后发生消化道出血，应考虑血管-肠瘘形成的可能性.
