The Difference in Success Rate of Endoscopic Stent Insertion with or without Fluoroscopic Guidance

Korean J Gastrointest Endosc > Volume 29(3); 2004 > Article

Korean Journal of Gastrointestinal Endoscopy 2004;29(3): 107-113.

방사선 투시 유무에 따른 내시경적 인공관 유치 성공률의 차이

조광범·장병국·박경식·정우진·황재석·안성훈·김갑철*·권중혁*·조창민^†

계명대학교 의과대학 내과학교실, *방사선학교실, ^†경북대학교 의과대학 내과학교실

The Difference in Success Rate of Endoscopic Stent Insertion with or without Fluoroscopic Guidance

Kwang Bum Cho, M.D., Byoung Kuk Jang, M.D., Kyung Sik Park, M.D., Woo Jin Chung, M.D., Jae Seok Hwang, M.D., Sung Hoon Ahn, M.D., Gap Chul Kim, M.D.*, Jung Hyeok Kwon, M.D.* and Chang Min Cho, M.D.^†

Departments of Internal Medicine and *Radiology, Keimyung University College of Medicine, ^†Internal Medicine, Kyungpook National University, Daegu, Korea

Abstract

Backgroud/Aims: Sometimes, the endoscopic stent insertion may be done without fluoroscopic guidance. This study was performed to evaluate the difference in success rate of endoscopic stent insertion with or without fluroscopic guidance. A total of hundred and sixty three patients with upper gastrointestinal obstruction were included.
Methods:
The group I comprised 82 patients in which the stent insertion was done without fluoroscopy. The group II included 81 patients in which stent was inserted under the fluoroscopy.
Results:
The locations of obstruction are at esophagus and cardia (group I /group II, 44/40 patients), at pylorus and duodenum (15/34 patients) and at post-operative stenosis of gastro-jejunal anastomosis (23/7 patients). The statistical difference of success rate were not found between the two groups [79/82 (96.3%) in group I, 80/81 (98.2%) in group II, p=0.620]. Among group I, three patients (3.7%) were failed due to incomplete guidewire insertion. These patients were the two cases of jejunal stenosis of esophago-jejunal anastomosis and one case of duodenal obstruction with carcinomatosis peritonei. However, in these cases, the stents were successfully inserted under the fluoroscopic guidance.
Conclusion:
The success rate of the endoscopic stent insertion with or without the fluoroscopic guidance is not different. But in cases of inaccurate guidewire insertion, especially in patients with pyloric obstruction, the endoscopic stent insertion under the fluoroscopic guidance may be more safe and successful. (Korean J Gastrointest Endosc 2004;29:107⁣113)

Key Words: Obstruction, Stent, Endoscopy

주요어: 내시경, 인공관 유치, 위장관 폐쇄