Ponsot P, Ruszniewski P
Service de gastroentérologie, hôpital Beaujon, Clichy, France.
Ann Chir. 2000 Jan;125(1):68-73.
This review outlines the indications and results of endoscopic management in the complications of chronic pancreatitis. Symptomatic obstructions of the main pancreatic duct can be treated by endocanalar prosthesis in case of fibrous stenosis and by extracorporeal shock wave lithotripsy in case of intraductal obstructive stones. Symptomatic or large pseudocysts have to be treated and may be treated by placement of transgastric or transduodenal endoprosthesis for pseudocysts protuding into the digestive tract and by using transpapillary endoprosthesis for communicating pseudocysts. Endoscopic treatment of ductal disruptions is difficult and generally requires combined techniques. Symptomatic biliary stenosis can be temporary treated using biliary endoprothesis. Short and long term results and complications of these different procedures are analysed. In the absence of controlled studies, the role of endoscopic treatment in comparison to surgical treatment is not well defined. Present indications for either approach can be discussed on an individual basis.
本综述概述了慢性胰腺炎并发症的内镜治疗指征及结果。对于主胰管的症状性梗阻，纤维性狭窄时可采用管腔内假体治疗，导管内梗阻性结石时可采用体外冲击波碎石术治疗。有症状的或较大的假性囊肿必须进行治疗，对于突入消化道的假性囊肿，可通过放置经胃或经十二指肠内假体进行治疗，对于交通性假性囊肿，可采用经乳头内假体进行治疗。导管破裂的内镜治疗困难，通常需要联合技术。症状性胆管狭窄可临时采用胆管内假体治疗。分析了这些不同手术的短期和长期结果及并发症。在缺乏对照研究的情况下，内镜治疗与手术治疗相比的作用尚不明确。目前两种治疗方法的指征可根据个体情况进行讨论。
