Provansal-Cheylan M, Bernard J P, Mariani A, Soehendra N, Cremer M, Sahel J, Sarles H
Chirurgische Klinik, Chir. Endoskopie, Universitätskrankenhaus Eppendorf, Hamburg.
Endoscopy. 1989 Mar;21(2):63-9. doi: 10.1055/s-2007-1012902.
One of the most common late complications of transpapillary pancreatic endoprostheses is clogging of the endoprosthesis lumen. In this study we analysed the morphology and the biochemical nature of the contents of 10 clogged pancreatic endoprostheses. At the optical level the sludge presented as an organic matrix with embedded small quantities of CaCO3 crystals (and in one case CaCO3 microcalculi). Electron microscopy showed the presence of bacterial ghosts and protein threads. The characteristic pattern of proteolysed pancreatic proteins was obtained when the organic matrix was analysed by SDS-Page. The presence of trypsinogen, amylase and one of the molecular secretory forms of Pancreatic Stone Protein (PSP) was confirmed by Western-blotting. PSP was also found in association with CaCO3 crystals by immunolocalization. These results suggest that endoprosthesis clogging is due to the precipitation of whole pancreatic juice protein, probably triggered by uncontrolled proenzyme activation.
经乳头胰内支架最常见的晚期并发症之一是内支架管腔堵塞。在本研究中，我们分析了10个堵塞的胰内支架内容物的形态和生化性质。在光学层面，淤渣呈现为含有少量碳酸钙晶体（在1例中为碳酸钙微结石）的有机基质。电子显微镜显示存在细菌菌影和蛋白质丝。通过SDS - 聚丙烯酰胺凝胶电泳分析有机基质时，获得了经蛋白水解的胰腺蛋白的特征图谱。通过蛋白质免疫印迹法证实了胰蛋白酶原、淀粉酶和胰腺结石蛋白（PSP）分子分泌形式之一的存在。通过免疫定位还发现PSP与碳酸钙晶体有关。这些结果表明，内支架堵塞是由于全胰液蛋白质沉淀所致，可能是由不受控制的酶原激活引发的。
