Güitron-Cantú Alfredo, Gutiérrez-Bermúdez José Antonio
Departamento de Endoscopia Digestiva, Hospital de Especialidades No. 71. Instituto Mexicano del Seguro Social, Torreón, Coahuila.
Rev Gastroenterol Mex. 2005 Jul;70 Suppl 1:121-32.
The role of endoscopic retrograde cholangiopancreatography (ERCP) in the management of pancreatic disease is continuing to evolve. In view of increasingly noninvasive diagnostic imaging modalities for pancreatic disease, ERCP should be mainly restricted to therapeutic indications. This article reviews recent publications spanning a wide range of topics related to therapeutic pancreatic endoscopy: This review article will be focused on the technical and therapeutic aspects of the following topics: 1. Post-ERCP pancreatitis and preventive methods for this entity, 2. Recurrent severe pancreatitis, 3. Oddi sphincter dysfunction, 4. Pancreatic duct stenosis and lithiasis in chronic pancreatitis, 5. Hereditary pancreatitis, 6. Pseudocysts and pancreatic abscesses, and 7. Pancreatic duct fistulae. Pancreatic endotherapy is technically demanding and potentially hazardous; these interventions should be restricted to high-volume centers with options for an interdisciplinary team approach. Methods that have not yet been established should be evaluated in carefully designed prospective trials.
内镜逆行胰胆管造影术（ERCP）在胰腺疾病管理中的作用正在不断演变。鉴于针对胰腺疾病的非侵入性诊断成像方式日益增多，ERCP应主要限于治疗指征。本文回顾了近期涉及治疗性胰腺内镜广泛主题的出版物：本综述文章将聚焦于以下主题的技术和治疗方面：1. ERCP术后胰腺炎及其预防方法，2. 复发性重症胰腺炎，3. 奥狄括约肌功能障碍，4. 慢性胰腺炎中的胰管狭窄和结石，5. 遗传性胰腺炎，6. 假性囊肿和胰腺脓肿，以及7. 胰管瘘。胰腺内镜治疗技术要求高且具有潜在风险；这些干预措施应限于具备跨学科团队协作条件的大容量中心。尚未确立的方法应在精心设计的前瞻性试验中进行评估。
