Kafka E C, Kalser M H
Postgrad Med. 1975 Jan;57(1):140-7. doi: 10.1080/00325481.1975.11713950.
New tests and test methods aid in the diagnosis of pancreatic disorders. Pancreatic carcinoma, especially, may have an improved prognosis with earlier detection as a result of refinements in arteriography, cytology, pancreatic radioisotopic scanning, and endoscopic retrograde cholangiopancreatography. Acute pancreatitis results most commonly from alcoholism, biliary tract disease, and trauma. Management is directed primarily at decreasing pancreatic exocrine secretion. Surgery is usually best avoided in the acute phase. Chronic pancreatitis is most often a result of recurrent attacks of acute pancreatitis. Diabetes and malassimilation become manifest as pancreatic destruction progresses. Management consists of replacement of pancreatic enzymes and diet supplements. Once chronic pancreatitis is established, surgery can only be directed at complications of the disease. Pancreatic ascites is usually associated with a break in the pancreatic ductal system. Ascites caused by trauma responds well to surgical intervention, but the alcoholic type is less amenable to treatment.
新的检测方法和检测手段有助于胰腺疾病的诊断。特别是胰腺癌，由于动脉造影、细胞学、胰腺放射性同位素扫描以及内镜逆行胰胆管造影技术的改进，早期检测可能会改善其预后。急性胰腺炎最常见的病因是酗酒、胆道疾病和外伤。治疗主要针对减少胰腺外分泌。急性期通常最好避免手术。慢性胰腺炎最常由急性胰腺炎反复发作引起。随着胰腺破坏的进展，糖尿病和消化吸收不良会逐渐显现。治疗包括补充胰酶和饮食补充剂。一旦确诊为慢性胰腺炎，手术只能针对该疾病的并发症。胰源性腹水通常与胰管系统破裂有关。外伤引起的腹水对手术干预反应良好，但酒精性腹水则较难治疗。
