Department of Surgery, Tianjin Nankai Hospital, Tianjin 300100, China. missyouxj@ 163.com
Hepatobiliary Pancreat Dis Int. 2011 Oct;10(5):539-43. doi: 10.1016/s1499-3872(11)60091-x.
The development of endoscopic techniques such as endoscopic retrograde cholangiopancreatography (ERCP), endoscopic sphincterotomy (EST) and stenting are relatively new alternatives to surgery for the treatment of benign lesions in the biliary duct and pancreas. The objective of this study was to assess the value of stenting in the endoscopic pancreatic duct and biliary duct in the treatment of chronic pancreatitis with distal benign biliary stricture.
Twenty-two patients diagnosed with chronic pancreatitis with distal benign biliary stricture underwent endoscopic treatment in our center, with ERCP, EST, endoscopic retrograde biliary drainage (ERBD) and endoscopic retrograde pancreatic drainage (ERPD) with stents. A numeric rating scale was used to assess pain intensity. The clinical data on endoscopic therapies and recovery of the patients were recorded and compared.
ERCPs were successfully performed in 21 patients and 1 (4.5%) failed because of pancreatic ductal variation. A total of 68 ERCPs were performed with 47 pancreatic duct stents and 39 biliary duct stents. The rate of complications was 13.2% (9/68). The abdominal pain score after endoscopic treatment was significantly reduced. The levels of bilirubin and alanine transaminase in all 21 patients were improved compared to those before endoscopic treatment.
Endoscopic stent drainage of the pancreatic duct and biliary duct for chronic pancreatitis with distal biliary benign stricture can be selected as a safe, effective and minimally invasive therapeutic method.
内镜逆行胰胆管造影术(ERCP)、内镜下括约肌切开术(EST)和支架置入等内镜技术的发展,为胆管和胰腺良性病变的治疗提供了相对较新的手术替代方案。本研究旨在评估支架置入术在治疗远端良性胆管狭窄的慢性胰腺炎中的价值。
22 例经诊断患有远端良性胆管狭窄的慢性胰腺炎患者在我院接受了内镜治疗,包括 ERCP、EST、内镜逆行胆道引流(ERBD)和支架置入的内镜逆行胰胆管引流(ERPD)。采用数字评分量表评估疼痛强度。记录并比较了患者的内镜治疗和康复的临床数据。
21 例患者成功进行了 ERCP,1 例(4.5%)因胰管变异而失败。共进行了 68 次 ERCP,其中 47 例放置了胰管支架,39 例放置了胆管支架。并发症发生率为 13.2%(9/68)。内镜治疗后,患者的腹痛评分明显降低。与内镜治疗前相比,所有 21 例患者的胆红素和丙氨酸转氨酶水平均有所改善。
对于远端胆管良性狭窄的慢性胰腺炎,内镜下胰胆管支架引流可作为一种安全、有效、微创的治疗方法。