[1]李文燕,冀明,张澍田.儿童慢性胰腺炎的病因及内镜在治疗中的价值[J].中国微创外科杂志,2012,12(7):615-617.
　Li Wenyan,Ji Ming,Zhang Shutian..Etiology of Chronic Pancreatitis in Children and Its Treatment with ERCPLi Wenyan, Ji Ming, Zhang Shutian. Department of Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China[J].Chinese Journal of Minimally Invasive Surgery,2012,12(7):615-617.
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儿童慢性胰腺炎的病因及内镜在治疗中的价值()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
12
期数:
2012年7期
页码:
615-617
栏目:
出版日期:
2012-07-20

文章信息/Info

Title:
Etiology of Chronic Pancreatitis in Children and Its Treatment with ERCPLi Wenyan, Ji Ming, Zhang Shutian. Department of Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
作者:
李文燕; 冀明; 张澍田
首都医科大学附属北京友谊医院消化内科，北京100050
Author(s):
Li Wenyan;  Ji Ming;  Zhang Shutian.
Department of Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
关键词:
慢性胰腺炎; 儿童; 病因
Keywords:
Chronic pancreatitis; Children; Etiology
分类号:
R726.1
文献标志码:
A
摘要:
目的探讨儿童慢性胰腺炎的病因和十二指肠镜在治疗中的价值。方法回顾性分析2006~2011年18例18岁以下因慢性胰腺炎行ERCP 40次的临床资料。年龄4~17岁，平均10.3岁。男8例，女10例，均存在上腹痛，影像学检查提示胰腺有异常表现。气管插管全麻下行ERCP。行狭窄括约肌切开、胰管狭窄段扩张、碎石、取石、胰管支架放置/鼻胰引流管放置等治疗。 结果18例40次ERCP操作，胰管插管成功39次（97.5%）。不明原因慢性胰腺炎11例（61.1%，其中2例以胰腺胸膜瘘发病），胰腺结构异常致慢性胰腺炎7例。全部患者症状消失。ERCP无严重并发症。9例结束治疗者随访1~39个月，均无腹痛发作。结论儿童慢性胰腺炎病因主要为特发性及结构异常，经十二指肠镜治疗微创、安全、有效。
Abstract:
ObjectiveTo investigate the causes of chronic pancreatitis in children and the value of duodenoscopy for the treatment. MethodsAn retrospective review on 18 children (10 girls and 8 boys, aged 4 to 17 years) with chronic pancreatitis, who underwent ERCP at our hospital between 2006 and 2011. The main clinical manifestation included epigastric pain and imaging suggesting abnormal pancreas. Under general anesthesia and tracheal cannulation, ERCP was performed. The therapeutic interventions included sphincterotomy, dilatation of the stenotic pancreatic duct, stone extraction, and stent insertion or nasopancreatic drainage. ResultsA total of 40 ERCP procedures were performed on the 18 children, 39 of them (97.5%) were successful. In our patients, 11 cases were idiopathic pancreatitis (61.1%, 2 of them had pancreaticpleural fistula), 7 were caused by pancreatic divisum and 4 biliopancreatic malformation. The symptoms of pancreatitis disappeared after ERCP in all the patients, without any severe complications occurred. Nine of the patients received a followup for 1 to 39 months, during which none of them complained of abdominal pain.ConclusionsThe main causes of pancreatitis in children are idiopathic and biliopancreatic malformation, for which ERCP is a safe and effective approach.

参考文献/References:

[1]李兆申.我国慢性胰腺炎临床流行病学特征.中国实用外科杂志2011，31（9）：770-772.
[2]中华医学会消化病学分会.慢性胰腺炎诊治指南(2005年,南京).中华消化杂志，2005，25（5）：319-320.
[3]中华医学会外科学分会胰腺外科学组.慢性胰腺炎诊治指南(讨论稿).中华肝胆外科杂志，2009，15（11）：851-854.
[4]Kozarek RA,Ball TJ,Patterson DJ,et al.Endoscopic pancreatic duct sphincterotomy:indications,technique,and analysis of results.Gastrointest Endosc,1994,40：592-598．
[5]汪鹏,张薇,刘枫,等.内镜下胰管括约肌切开术后早期并发症的前瞻性研究.中华消化内镜杂志,2009，26（1）:23-27.
[6]Pungpapong S,Wallace MB,Woodward TA,et al.Accuracy of endoscopic ultrasonography and magnetic resonance cholangiopancreatography for the diagnosis of chronic pancreatitis:a prospective comparison study.J Clin Gastroenterology,2007,41(1):88-93.
[7]Sakai Y,Tsuyuguchi T,Tsuchiya S,et al.Diagnostic value of MRCP and indications for ERCP.Hepatogastroenterology,2007，54(80):2212-2215.
[8]Wang W,Liao Z,Li ZS,et al.Chronic pancreatitis in Chinese children:etiology,clinical presentation and imaging diagnosis.J Gastroenterol Hepatol,2009,24(12):1862-1868.
[9]Lee YJ,Kim KM,Choi JH,et al..High incidence of PRSS1 and SPINK1 mutations in Korean children with acute recurrent and chronic pancreatitis.J Pediatr Gastroenterol Nutr,2011,52(4):478-481.
[10]Lucidi V,Alghisi F,Dall’Oglio L,et al.The etiology of acute recurrent pancreatitis in children:a challenge for pediatricians.Pancreas,2011,40(4):517-521.
[11]刘奇才,程祖建,杨艳,等.一个遗传性胰腺炎家系中新发现的胰蛋白酶原基因突变.遗传，2007,29(9):1067-1070.
[12]Otto AK,Neal MD,Slivka AN,et al.An appraisal of endoscopic retrograde cholangiopancreatography (ERCP) for pancreaticobiliary disease in children:our institutional experience in 231 cases.Surg Endosc,2011,25(8):2536-2540.

更新日期/Last Update: 2013-04-03