François Erik, Kahaleh Michel, Giovannini Marc, Matos Celso, Devière Jacques
Department of Gastroenterology, Hôpital Erasme, Brussels, Belgium.
Gastrointest Endosc. 2002 Jul;56(1):128-33. doi: 10.1067/mge.2002.125547.
The pain of chronic pancreatitis can be caused by pancreatic ductal hypertension, and endoscopic drainage of the main pancreatic duct can provide relief. When transpapillary access to a dilated portion of the main duct cannot be obtained, conventional endoscopic drainage is not possible. The use of interventional EUS to perform a pancreaticogastrostomy in such cases is described.
Four patients presented with pain and a dilated main pancreatic duct proximal to a complete obstruction. EUS was used to access the dilated duct and create a pancreaticogastrostomy. Patency of the latter was maintained by placement of a pancreaticogastric stent.
EUS-guided pancreaticogastrostomy was performed without major complication. Three of 4 patients had satisfactory relief of pain at a median follow-up of 1 year.
EUS-guided pancreaticogastrostomy may be a promising new technique for pancreatic drainage and pain relief when conventional transpapillary access to the pancreatic duct is not possible.
慢性胰腺炎的疼痛可能由胰管高压引起，主胰管的内镜下引流可缓解疼痛。当无法经乳头进入主胰管的扩张部分时，传统的内镜引流就无法进行。本文描述了在这种情况下使用介入性超声内镜进行胰胃吻合术。
4例患者出现疼痛，主胰管在完全梗阻近端扩张。使用超声内镜进入扩张的胰管并进行胰胃吻合术。通过放置胰胃支架维持后者的通畅。
超声内镜引导下胰胃吻合术未发生重大并发症。4例患者中有3例在中位随访1年时疼痛得到满意缓解。
当无法通过传统经乳头途径进入胰管时，超声内镜引导下胰胃吻合术可能是一种有前景的胰管引流和缓解疼痛的新技术。
