[1]常虹,陈佩婷,刘文正,等.胰管括约肌切开联合胰管支架对胆道微结石性急性复发性胰腺炎的疗效评价[J].中国微创外科杂志,2016,16(12):1080-1084.
 Chang Hong,Chen Peiting,Liu Wenzheng,et al.Clinical Outcomes of Endoscopic Pancreatic Sphincterotomy Combined with Pancreatic Duct Stenting for Acute Recurrent Pancreatitis Caused by Biliary Microlithiasis[J].Chinese Journal of Minimally Invasive Surgery,2016,16(12):1080-1084.
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胰管括约肌切开联合胰管支架对胆道微结石性急性复发性胰腺炎的疗效评价()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
16
期数:
2016年12期
页码:
1080-1084
栏目:
临床论著
出版日期:
2016-12-20

文章信息/Info

Title:
Clinical Outcomes of Endoscopic Pancreatic Sphincterotomy Combined with Pancreatic Duct Stenting for Acute Recurrent Pancreatitis Caused by Biliary Microlithiasis
作者:
常虹陈佩婷刘文正张耀朋姚炜李柯黄永辉**
北京大学第三医院消化科,北京100083
Author(s):
Chang Hong Chen Peiting Liu Wenzheng et al.
Department of Gastroenterology, Peking University Third Hospital, Beijing 100083, China
关键词:
急性复发性胰腺炎胆道微结石胰管括约肌切开术
Keywords:
Acute recurrent pancreatitisBiliary microlithiasisEndoscopic pancreatic sphincterotomy
文献标志码:
A
摘要:
目的探讨胰管括约肌切开(endoscopic pancreatic sphincterotomy,EPS)联合胰管支架置入术治疗胆道微结石性急性复发性胰腺炎的可行性。方法回顾性分析2005年4月~2014年4月我院诊断急性复发性胰腺炎(2次及以上急性胰腺炎发作)且明确病因为胆道微结石52例资料,24例行EPS并胰管支架置入术(EPS组),28例行内镜下乳头括约肌切开(endoscopic sphincteropapillotomy,EST)并胆道清理术(其中20例鼻胆管引流术)(EST组),比较2组复发率、术后近期和远期并发症。 结果52例中术后胰腺炎9例,其中EPS组6例(25.0%,6/24),EST组3例(10.7%,3/28),无统计学差异(χ2=0.980,P=0.322)。EPS组随访3~100个月,中位数33个月;EST组随访3~115个月,中位数52个月。5例急性胰腺炎复发,EPS组2例(8.3%,2/24),EST组3例(10.7%,3/28),无统计学差异(χ2=0.000,P=1.000)。EPS组和EST组胆道远期并发症发生率分别为8.3%(2/24)和32.1%(9/28),有统计学差异(χ2=4.392,P=0.046)。 结论EPS联合胰管支架置入术治疗胆道微结石导致的急性复发性胰腺炎是可行的。胰管括约肌切开不会引起反流,且能保留胆管括约肌功能。
Abstract:
ObjectiveTo investigate the feasibility of endoscopic pancreatic sphincterotomy (EPS) combined with pancreatic duct stenting for acute recurrent pancreatitis (ARP) caused by biliary microlithiasis.MethodsThe clinical data of 52 cases of ARP (2 or more attacks of acute pancreatitis) diagnosed in our hospital from April 2005 to April 2014 were retrospectively analyzed. There were 24 cases in EPS group with pancreatic stenting and 28 cases in EST (endoscopic sphincteropapillotomy) group (20 cases with EPBD). The rate of recurrence and incidence of the early and late complication were compared between the two groups. ResultsThere were 9 cases of post ERCP pancreatitis after the endoscopic therapy, including 6 cases (25.0%) in the EPS group and 3 cases (10.7%) in the EST group. There was no statistical difference between the two groups (χ2=0.980, P=0.322). During the follow-up in the EPS group (median, 33 months; range, 3-100 months) and in the EST group (median, 52 months; range, 3-115 months), recurrence of acute pancreatitis occurred in 5 patients, including 2 cases in the EPS group (8.3%) and 3 in the EST group (10.7%). There was no statistical difference between the two groups (χ2=0.000, P=1.000). The incidence of long-term complications was 8.3% (2/24) in the EPS group and 32.1% (9/28) in the EST group, showing significant difference (χ2=4.392, P=0.046). ConclusionsEPS combined with pancreatic stenting in the treatment of acute recurrent pancreatitis caused by biliary calculi is feasible. EPS does not cause reflux and help recover the biliary sphincter function.

参考文献/References:

[1]Testoni PA.Acute recurrent pancreatitis:etiopathogenesis,diagnosis and treatment.World J Gastroenterol,2014,20(45):16891-16901.
[2]Banks PA,Bollen TL,Dervenis C,et al.Classification of acute pancreatitis-2012:revision of the Atlanta classification and definitions by international consensus.Gut,2013,62(1):102-111.
[3]中华医学会消化病学分会胰腺疾病学组,中华胰腺病杂志编辑委员会与中华消化杂志编辑委员会.中国急性胰腺炎诊治指南(2013年,上海).胃肠病学,2013,18(7):428-433.
[4]Yoon LY,Moon JH,Choi HJ,et al.Clinical usefulness of intraductal ultrasonography for the management of acute biliary pancreatitis.J Gastroenterol Hepatol,2015,30(5):952-956.
[5]Menon S.Biliary microlithiasis.Gastrointest Endosc,2009,69(6):1197-1198.
[6]Cotton PB,Lehman G,Vennes J,et al.Endoscopic sphincterotomy complicant and their management: an attempt at consensus.Gastrointest Endosc,1991,37(3):383-393.
[7]Houssin D,Castaing D,Lemoine J,et al.Microlithiasis of the gallbladder.Surg Gynecol Obstet,1983,157(1):20-24.
[8]Rty S,Pulkkinen J,Nordback I,et al.Can laparoscopic cholecystectomy prevent recurrent idiopathic acute pancreatitis?a prospective randomized multicenter trial.Ann Surg,2015,262(5):736-741.
[9]Acosta JM,Ledesma CL.Gallstone migration as a cause of acute pancreatitis.N Engl J Med,1974,290(9):484-487.
[10]Bor R,Madácsy L,Fábián A,et al.Endoscopic retrograde pancreatography:when should we do it?World J Gastrointest Endosc,2015,7(11):1023-1031.
[11]Choudhary A,Bechtold ML,Arif M,et al.Pancreatic stents for prophylaxis against post-ERCP pancreatitis:a meta-analysis and systematic review.Gastrointest Endosc,2011,73(2):275-282.
[12]常虹,黄永辉,段丽萍,等.复发性特发性胰腺炎内镜治疗的临床分析.中华胰腺病杂志,2012,12(2):83-85.
[13]Doi S,Yasuda I,Mukai T,et al.Comparison of long-term outcomes after endoscopic sphincterotomy versus endoscopic papillary balloon dilation:a propensity score-based cohort analysis.J Gastroenterol,2013,48(9):1090-1096.

备注/Memo

备注/Memo:
基金项目:首都市民健康项目培育(Z141100002114017)**通讯作者,E-mail: huangyonghui@medmail.com.cn
更新日期/Last Update: 2017-03-09