摘要
目的 探讨内镜治疗胰管狭窄的临床疗效。方法 36例影像学检查确诊的胰管狭窄患者,病因包括慢性胰腺炎、胰腺分裂症、胰头癌、胰腺假性囊肿等,分别在内镜逆行胰胆管造影基础上行内镜治疗,包括胰管支架置入、气囊扩张、探条扩张以及经内镜胰管括约肌切开术（EPS）、经内镜乳头括约肌切开术（EST）,同时观察术后症状缓解情况（如腹痛缓解率）、并发症发生率以及近期与远期疗效。结果36例分别进行了胰管支架引流术、气囊扩张、探条扩张、EPS和EST,术后腹痛症状有不同程度的改善,并发症发生率较低。随访1个月～36个月,平均15个月。术后近期（≤3个月）腹痛缓解率为72.2％（26/36）,长期（>3个月）随访显示47.2％（17/36）的患者腹痛缓解无复发,63.9％（23/36）的患者体重增加,生活质量改善。高淀粉酶血症、出血的发生率分别为13.9％（5/36）和5.6％（2/36）,均经一般内科治疗于3日内缓解。支架阻塞、支架脱落的发生率分别为12.5％（3/24）和4.2％（1/24）。结论 经内镜治疗胰管狭窄是安全而有效的方法。
Objective To study the safety and efficacy of endoscopic therapy in patients with pancreatic duct stricture. Methods A total of 36 consecutive patients (25 males, 11 females) were recruited for endoscopic therapy of pancreatic duct stricture due to various pancreatic disorders including chronic pancreatitis, pancreas divisum, tumor in pancreatic head and pancreatic pseudocysts. Pancreatic stenting,stricture dilation, endoscopic pancreatic sphincterotomy ( EPS) and endoscopic sphincterotomy ( EST ) were performed after endoscopic retrograde cholangiopancreatography(ERCP). The relief rate of abdominal pain and incidence of complication in interventional endoscopy were observed; the short and long - term outcome were assessed. Results In 36 patients all procedures including pancreatic stenting, stricture dilation, EPS and EST were successful. Follow - up ranged from 1 to 36 months ( mean, 15months). Short - term follow - up (≤3 months) showed that 72. 2% of 36 patients had pain relief and long - term follow - up(>3 months) showed that 47. 2% of 36 patients had persistent relief without pain recurrence. Besides pain relief, the interventional endoscopy resulted in weight gain and improvement in quality of life in 63. 9% of 36 patients. Furthermore, the incidences of hyperamylasemia and bleeding which recovered after medication only within 3 days were 13. 9% and 5. 6% , respectively. Stent occlusion and detachment occurred respectively in 12. 5% and 4. 2% of 24 patients undergoing stent placement. Conclusion Endoscopic therapy for patients with pancreatic duct stricture appears to be safe and effective.
出处
《中华消化内镜杂志》
2002年第5期268-270,共3页
Chinese Journal of Digestive Endoscopy
关键词
胰管狭窄
胰胆管造影术
内窥镜逆行
治疗学
Pancreatic duct stricture
Endoscopic retrograde cholangiopancreatography
Therapeutics
