Yoon Jai Hoon, Choi Ho Soon, Baeg Sang Hyeon, Lee Oh Young, Yoon Byung Chul, Kwon Jung Kyun, Kim Won Kyu
Department of Internal Medicine, Hanyang University College of Medicine, Seongdong-gu, Seoul, Korea.
Korean J Gastroenterol. 2006 Feb;47(2):153-8.
The pancreatic duct stenting is now recognized as the treatment option for a number of pancreatic disorders. Although the stent-induced ductal changes may result, there is little information regarding the frequency of these stent-induced changes in chronic pancreatitis. Pancreatic stents may occlude with time, but there is only little information available on the nature of the clogging process. Although a short-term efficacy of endoscopic pancreatic duct stenting has been proved, the long-term efficacy continues to be controversial. The aim of this study was to report a case of chronic pancreatitis with pancreatolith after the incidental long-term pancreatic stenting for 3 years due to a pancreas divisum with acute pancreatitis. Also, this study described the analysis of the ultrastructural changes in the surface of an occluded pancreatic stent. A scanning and transmission electron microscopy showed an amorphous protein matrix in whole stent that arranged as a network in some areas but arranged as the layers in other areas. A variable number of bacteria of mixed species, calcium carbonate or calcium oxalate crystal, round leukocyte were scattered in the protein matrix. The yeast and plant material were seen in some part of the stent as well.
胰管支架置入术目前被认为是多种胰腺疾病的治疗选择。尽管可能会出现支架引起的导管改变，但关于慢性胰腺炎中这些支架引起的改变的发生率的信息却很少。胰管支架可能会随着时间的推移而堵塞，但关于堵塞过程的性质的可用信息却很少。尽管内镜下胰管支架置入术的短期疗效已得到证实，但其长期疗效仍存在争议。本研究的目的是报告一例因胰腺分裂合并急性胰腺炎而意外长期置入胰管支架3年后出现胰腺结石的慢性胰腺炎病例。此外，本研究还描述了对堵塞的胰管支架表面超微结构变化的分析。扫描电子显微镜和透射电子显微镜显示，整个支架内有非晶态蛋白质基质，在某些区域呈网络状排列，而在其他区域呈层状排列。在蛋白质基质中散在分布着数量不等的混合菌种细菌、碳酸钙或草酸钙晶体、圆形白细胞。在支架的某些部位还可见酵母和植物物质。
