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慢性胰腺炎的外科治疗

Surgery for chronic pancreatitis.

作者信息

Perwaiz Azhar, Singh Amanjeet, Chaudhary Adarsh

机构信息

Department of GI Surgery, GI Oncology and Bariatric Surgery, Room No-10, 11th floor, OPD block, Medanta, The Medicity, Sector-38, 12001 Gurgaon, Haryana India.

出版信息

Indian J Surg. 2012 Feb;74(1):47-54. doi: 10.1007/s12262-011-0374-7. Epub 2011 Dec 20.

Abstract

Chronic pancreatitis (CP) is progressive inflammatory process of the pancreas. Abdominal pain remains the most debilitating symptom affecting quality of life, apart from diabetes mellitus, steatorrhoea and weight loss. The treatment options have evolved over the past decades and are aimed to provide durable relief in pain with possible attempt to support or improve the failing endocrine and exocrine functions. Surgical treatment options have shown the potentials to provide superior long term results compared to the pharmacological and endoscopic modalities and are broadly divided in to drainage, resection and combination hybrid procedures. The choice is based on the morphology of the main pancreatic duct, presence of head mass and associated complication of CP. Knowing the basic nature of the disease, total pancreatectomy seems a curative option but not without significant morbidities. There is recent paradigm shift towards organ sparing surgical procedures with reasonable success. Despite recent advancement in the treatment modalities for CP the overall quality of life remains moderate which need further addressal.

摘要

慢性胰腺炎(CP)是胰腺的进行性炎症过程。除了糖尿病、脂肪泻和体重减轻外,腹痛仍然是影响生活质量最使人衰弱的症状。在过去几十年中,治疗选择不断发展,旨在持久缓解疼痛,并可能尝试支持或改善衰竭的内分泌和外分泌功能。与药物和内镜治疗方式相比,手术治疗选择已显示出提供更优长期效果的潜力,大致分为引流、切除和联合混合手术。选择基于主胰管的形态、胰头肿块的存在以及CP的相关并发症。了解该疾病的基本性质后,全胰切除术似乎是一种治愈性选择,但并非没有重大并发症。最近出现了向保留器官手术程序的范式转变,并取得了一定成功。尽管CP的治疗方式最近有所进展,但总体生活质量仍然一般,这需要进一步解决。

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