术前内镜下胰腺支架置入术预防胰体尾切除术后胰瘘的发生
Preoperative endoscopic pancreatic stenting for prophylaxis of pancreatic fistula development after distal pancreatectomy.
作者信息
Abe Nobutsugu, Sugiyama Masanori, Suzuki Yutaka, Yamaguchi Yasuharu, Yanagida Osamu, Masaki Tadahiko, Mori Toshiyuki, Atomi Yutaka
机构信息
Department of Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan.
出版信息
Am J Surg. 2006 Feb;191(2):198-200. doi: 10.1016/j.amjsurg.2005.07.036.
BACKGROUND AND OBJECTIVE
Pancreatic fistula is a common complication of distal pancreatectomy (DP). Although various surgical procedures have been proposed for DP in an attempt to decrease the high incidence of pancreatic fistula, the prevention of pancreatic fistula remains a major problem in DP. Endoscopic pancreatic stenting for the treatment or prophylaxis of such a fistula has been rarely described.
METHODS
We reviewed 9 patients who underwent preoperative endoscopic pancreatic stenting for the prophylaxis of pancreatic fistula development after DP.
RESULTS
Preoperative endoscopic pancreatic stenting was successfully performed with a 7F stent in all the 9 patients. Two patients, both with intraductal papillary mucinous tumor, developed mild acute pancreatitis after the stent placement. None of the 9 patients developed pancreatic fistula. The pancreatic stent was removed from 8 to 28 days (mean 11 days) postoperatively.
CONCLUSIONS
Preoperative endoscopic pancreatic stenting may be an effective prophylactic measure against pancreatic fistula development following DP in selected patients.
背景与目的
胰瘘是胰体尾切除术（DP）的常见并发症。尽管已经提出了各种手术方法来进行胰体尾切除术，试图降低胰瘘的高发生率，但胰瘘的预防仍然是胰体尾切除术中的一个主要问题。关于内镜下胰腺支架置入术用于治疗或预防此类瘘的报道很少。
方法
我们回顾了9例接受术前内镜下胰腺支架置入术以预防胰体尾切除术后胰瘘发生的患者。
结果
所有9例患者均成功置入7F支架进行术前内镜下胰腺支架置入术。2例均为导管内乳头状黏液瘤的患者在支架置入后发生轻度急性胰腺炎。9例患者均未发生胰瘘。术后8至28天（平均11天）取出胰腺支架。
结论
对于部分患者，术前内镜下胰腺支架置入术可能是预防胰体尾切除术后胰瘘发生的有效措施。
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