肝胆胰外科杂志2026，Vol.38Issue(10)：735-739,5.DOI:10.11952/j.issn.1007-1954.2026.10.009
锥形透明帽辅助异物钳经PTCD途径取出全覆膜金属支架的临床观察
Clinical observation of fully covered metal stent removal via the percutaneous transhepatic cholangial drainage approach using a conical transparent cap-assisted grasping forceps
摘要
Abstract
Inserting a fully covered metal stent(FCMS)via percutaneous transhepatic cholangial drainage(PTCD)approach is an effective method for treating benign bile duct stenosis.However,the inserted FCMS needs to be removed through the fistula with grasping forceps under the direct visualization of the choledochoscope,and the fistula needs to be dilated before FCMS removal,which is cumbersome and has a long treatment course.Our team has designed a conical transparent cap(ZL202121268879.X)and applied it in clinical practice.In order to investigate the feasibility and safety of this conical transparent cap-assisted grasping forceps in FCMS removal via the PTCD approach,a retrospective analysis was conducted on the clinical data of 9 patients with benign bile duct stenosis who were admitted to Cholelithiasis Center of East Hospital Affiliated to Tongji University from January 2025 to December 2025,including 5 males and 4 females,with an average age of(58.67±5.59)years.The types of bile duct stenosis included 3 cases of cholangioenterostomy anastomostic stenosis,2 cases of iatrogenic right hepatic duct stenosis,1 case of iatrogenic hepatic common duct stenosis,and 3 cases of inflammatory bile duct sphincter stenosis.All 9 patients were successfully treated with FCMS through PTCD fistula.One patient experienced liver dysfunction after FCMS placement,which improved after conservative treatment.None of the cases experienced early complications such as acute cholangitis,acute cholecystitis,or acute pancreatitis.The mean time of FCMS retention was(5.22±1.09)months.None of the cases experienced long-term complications such as obstructive jaundice,liver abscess,or biliary stricture.The success rate of FCMS removal was 100%(9/9),the time required to remove FCMS was(5.22±0.67)min and the difficulty score of operation was(8.89±1.05)points.No postoperative complications such as hemorrhage,bile leakage,or acute cholangitis occurred.During 3 to 15 months of follow-up,re-examination of hepatobiliary and pancreatic MRI and MRCP showed no recurrence of bile duct stones or stenosis.Our research shows that the conical transparent cap-assisted grasping forceps is a feasible and safe method for FCMS removal via the PTCD approach.关键词
全覆膜金属支架/锥形透明帽/导丝/异物钳/经皮肝穿刺胆管引流/支架取出Key words
fully covered metal stent/conical transparent cap/guidewire/grasping forceps/percutaneous transhepatic cholangial drainage/stent removal分类
医药卫生引用本文复制引用
单凯,张诚,杨玉龙,于海洋,何川琦,祁春春..锥形透明帽辅助异物钳经PTCD途径取出全覆膜金属支架的临床观察[J].肝胆胰外科杂志,2026,38(10):735-739,5.基金项目
上海市浦东新区卫生系统重点专科项目(PWZzk2022-17). （PWZzk2022-17）
