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慢性胰腺炎患者的胰管内镜括约肌切开术:171例连续患者的单中心经验

Pancreatic endoscopic sphincterotomy in patients with chronic pancreatitis: a single-center experience in 171 consecutive patients.

作者信息

Jakobs R, Benz C, Leonhardt A, Schilling D, Pereira-Lima J C, Riemann J F

机构信息

Dept. of Gastroenterology, Ludwigshafen Hospital (Academic Hospital of the University of Mainz), Ludwigshafen, Germany.

出版信息

Endoscopy. 2002 Jul;34(7):551-4. doi: 10.1055/s-2002-33211.

Abstract

BACKGROUND AND STUDY AIMS

In recent years, interest in endoscopic therapy techniques for pancreatic diseases has been constantly increasing. The aim of the present study was to assess the technical success, technique, and complications of endoscopic pancreatic sphincterotomy (EPS) in patients with chronic pancreatitis.

PATIENTS AND METHODS

A total of 171 patients with chronic pancreatitis and abdominal complaints were identified in whom at least one attempt at EPS was carried out. During the procedure, sphincterotomy was carried out using a guide-wire sphincterotome or a needle-knife papillotome. Patients were followed up after EPS for at least 24 h, including clinical symptoms and laboratory data (pancreatic enzymes and hemoglobin/hematocrit).

RESULTS

EPS was performed in 167 of the 171 patients (technical success rate: 97.7 %). In 24 patients (14 %), a precut technique was necessary using a needle-knife sphincterotome. Sphincterotomy-related complications were observed in seven of the 171 patients (4.1 %), including three cases of bleeding, three patients with mild pancreatitis, and one with retroduodenal perforation. All complications were managed medically. There was no treatment-related mortality.

CONCLUSIONS

Endoscopic sphincterotomy of the pancreatic duct in patients with chronic pancreatitis is a fairly safe procedure with a high technical success rate.

摘要

背景与研究目的

近年来,人们对胰腺疾病内镜治疗技术的兴趣不断增加。本研究的目的是评估慢性胰腺炎患者内镜下胰管括约肌切开术(EPS)的技术成功率、技术方法及并发症。

患者与方法

共纳入171例有腹部症状的慢性胰腺炎患者,这些患者至少接受过1次EPS尝试。手术过程中,使用导丝括约肌切开刀或针刀乳头切开刀进行括约肌切开术。EPS术后对患者进行至少24小时的随访,包括临床症状和实验室数据(胰酶及血红蛋白/血细胞比容)。

结果

171例患者中有167例接受了EPS(技术成功率:97.7%)。24例患者(14%)需要使用针刀括约肌切开刀进行预切开技术。171例患者中有7例(4.1%)观察到与括约肌切开术相关的并发症,包括3例出血、3例轻度胰腺炎和1例十二指肠后穿孔。所有并发症均经药物治疗。无治疗相关死亡病例。

结论

慢性胰腺炎患者的内镜下胰管括约肌切开术是一种相当安全的手术,技术成功率高。

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