The difference between plastic brackets and metal brackets
Biliary stent implantation is mainly suitable for the treatment of benign and malignant biliary strictures and biliary fistula that are not suitable or unwilling to operate. The causes of benign biliary stricture include biliary surgery injury, trauma, sclerosing cholangitis, suppurative cholangitis, chronic pancreatitis, calori's disease and so on.
Stent implantation is also an ideal choice for bile duct stenosis after liver transplantation and hepatic arterial infusion chemotherapy. The main causes of malignant biliary obstruction are pancreatic cancer, cholangiocarcinoma, ampullary cancer, duodenal cancer, gallbladder cancer, liver cancer and hilar lymph node metastasis. The main causes of biliary fistula are biliary tract injury, obstruction and infection. Pancreatic cancer with jaundice is the main cancer in biliary stent implantation.
According to the different materials of stents, they are mainly divided into plastic stents and metal stents. What are the characteristics of different biliary stents?
A, plastic bracket:
1. Advantages: good short-term drainage effect and low price.
2. Disadvantages: The plastic stent will be narrowed due to the deposition of bile mud after being placed for a long time.
3. It is mainly suitable for the preoperative treatment of diseases requiring short-term placement, such as benign bile duct stenosis and malignant bile duct obstruction.
2. Metal bracket: Self-expanding metal bracket is the main one.
1. Advantages: Because the expanded diameter of the metal bracket is several times that of the plastic bracket, and it is not easy to slide down, the drainage effect is obviously better than that of the plastic bracket; Can keep the biliary tract unobstructed for a long time; The contact area between stent and bile duct wall is small, which can be covered by bile duct epithelium after several weeks, and it is not easy to be infected to form bile mud, so it is widely used in the treatment of malignant biliary obstruction.
2. Disadvantages, such as it is difficult to take out after successful indwelling, and the non-surgical approach is almost irreplaceable; Tumors can grow in the gap of the stent, causing re-obstruction; It is more expensive.
3. Mainly applicable to: 1) clinical or pathological diagnosis of malignant biliary obstruction without surgical indications; 2) The tumor has no intrahepatic or distant metastasis, and the expected survival time is more than 3 months; 3) No other serious diseases.