Korean Journal of Gastrointestinal Endoscopy 2009;38(4): 193-198.
이중막 구조의 스텐트를 이용한 악성 위 배출구 폐쇄의 치료에서 추가적인 지혈용 클립 부착의 유용성
정우진ㆍ강대환ㆍ최철웅ㆍ김형욱ㆍ김광하ㆍ허정ㆍ송근암ㆍ조몽ㆍ정경식ㆍ김용욱ㆍ김동욱ㆍ김표준ㆍ김일두
부산대학교 의과대학 내과학교실
The Usefulness of Applying an Additional Clip When Using a Double-layered Pyloric Stent to Treat Gastric Outlet Obstruction
Woo Jin Jung, M.D., Dae Hwan Kang, M.D., Cheol Woong Choi, M.D., Hyung Wook Kim, M.D., Gwang Ha Kim, M.D., Jeong Heo, M.D., Geun Am Song, M.D., Mong Cho, M.D., Kyung Sik Jung, M.D., Yong Wuk Kim, M.D., Dong Uk Kim, M.D., Pyo Jun Kim, M.D. and Il Du Kim, M
Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
Abstract
Background/Aims: It has been reported the placement of a double-layered pyloric combination stent can overcome the disadvantage of the increased ingrowth observed for an uncovered stent and the increased migration for a covered stent. But this did not satisfactorily prevent stent migration and it caused stent migration more frequently than with using the uncovered stent. This study evaluated the usefulness of applying a clip in an effort to reduce stent migration. Methods: Fifteen patients with malignant gastric outlet obstruction were treated with endoscopic placement of a double-layered combination pyloric stent. Three endoscopic clips were then applied to fix the proximal end of the enteral stent to the gastric or duodenal mucosa. The clinical efficacy and especially the rate of migration were analyzed. Results: The technical and clinical success rate was 100% (15/15) and 93.3% (14/15), respectively. No stent migration was observed in any of the patients. Three patients (20%) experienced complications such as stent collapse. The median stent patency period was 83.4 days. Conclusions: Endoscopic clipping for enteral stent placement is effective for preventing stent migration in patients with malignant gastric outlet obstruction. (Korean J Gastrointest Endosc 2009;38:193-198)
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