摘要
目的:探讨内镜在治疗慢性胰腺炎胰管结石中的应用价值。方法:121例胰管结石患者中,行内镜取石术(ERCP、EPS、网篮取石)68例,内镜引流术(ERCP、EPS、ERPD)41例,12例内镜治疗未成功行胰管空肠Roux-en-Y吻合术10例,胰十二指肠切除术2例。结果:内镜治疗后19例出现不同程度的高胰酶血症,出现轻型胰腺炎症状者14例,上消化道出血2例,急性胆管炎5例,均经保守治疗治愈。随访病人1～58个月,19例失访。102例中内镜治疗成功91例,其中腹痛症状缓解或消失者82例,7例分别在内镜治疗后2～16个月出现支架堵塞和移位再次行内镜治疗。结论:内镜治疗胰管结石具有创伤小、可多次重复性操作的优点,但也应避免反复操作引起的高淀粉酶血症及胰腺炎的发生。术后应定期复诊,及时发现胰管支架的堵塞及移位。
Objective To explore the value of endoscopic treatment in pancreatic ductal stones（PDS） and analyze the successful rate of endoscopic treatment and stone extraction. Methods In 121 patients with endoscopic stones successful extractions were performed in 68 cases, endoscopic retrograde pancreatic drainage in 41 cases, and 12 patients who failed in endoscopic treatment underwent surgical operations. Results Postoperative complications occurred in 40 patients including 19 cases of hyperamylasemia, 14 of mild acute pancreatitis, 2 of upper gastrointestinal hemorrhage and 5 of acute cholangitis. All these 40 patients were cured by conservative treatment. One hundred and two patients of the 121 patients were followed up from one to 58 months, 19 patients were lost. In those 102 cases 91 successfully underwent endoscopic treatment and abdominal pain disappeared in 82 cases （90.1%）. Seven patients （11.1%） received extra endoscopic treatment for stent blockage and shift after 2～16 months of the first treatment. Conclusion Endoscopic treatment of pancreatic ductal stones is a choice with minimally invasive and repetitive operation. But acute pancreatitis and hyperamylasemia resulting from repetitive endoscopic treatments should be avoided . Postoperative review is important in case of pancreatic duct stent occlusion and displacement.
出处
《中国中西医结合外科杂志》
CAS
2011年第1期27-30,共4页
Chinese Journal of Surgery of Integrated Traditional and Western Medicine
关键词
内镜
胰管结石
胰管支架
endoscopy
pancreatic ductal stones
endoscopic retrograde pancreatic drainage
