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[慢性胰腺炎:临床与治疗研究。一个胃肠病学科六年的经验]

[Chronic pancreatitis: clinical and therapeutic study. Six years of experience of a gastroenterology department].

作者信息

Hefaiedh Rania, Sabbeh Mariem, Ouakaa-Kchaou Asma, Gargouri Dalila, Héla Elloum, Kochlef Asma, Kharrat Jamel, Ghorbel Adbeljabbar

出版信息

Tunis Med. 2015 Feb;93(2):69-72.

Abstract

BACKGROUND

The chronic pancreatitis is an inflammatory chronic affection of the pancreatic parenchyma characterized by a mutilating fibrosis with a progressive set up. The endoscopic treatment is actually considered as the first-line treatment and can sometimes be complementary to surgery.

AIM

To determine the epidemiological, clinical, para-clinical and therapeutic characteristics during chronic pancreatitis.

METHODS

a retrospective study including patients having a chronic pancreatitis hospitalized in the gastroenterology department of Habib Thameur hospital between 2002 and 2008 was performed.

RESULTS

Sixteen patients were included in this study (mean age 43 years, sex ratio 7). All the patients were symptomatic at the time of the diagnosis and the epigastric pain was the main symptom. A complication was noted at the time of diagnosis in 12 patients: endocrine and exocrine pancreatic failure was noted in respectively 5 and 3 patients, while other complications were less frequent: acute pancreatitis (2 patients), cholestatic jaundice (2 patients) and pancreatic pseudo-cyst (2 patients). The endoscopic treatment was performed in 62% of the patients with success of 63%. The surgical treatment was indicated in 37% of the cases. Mean follow up was 16 months. Survival rate was 93% at one year. One patient died because of hypoglycemia. No pancreatic neoplasia was noted in our study.

CONCLUSION

In chronic pancreatitis, the contribution of endoscopic treatment is considerable but not without a certain risk. Therefore, collaboration between surgeons and endoscopists is needed and the best treatment should be considered individually.

摘要

背景

慢性胰腺炎是胰腺实质的一种慢性炎症性疾病,其特征为进行性发展的致残性纤维化。内镜治疗目前被视为一线治疗方法,有时可作为手术的补充。

目的

确定慢性胰腺炎的流行病学、临床、辅助检查及治疗特征。

方法

进行一项回顾性研究,纳入2002年至2008年期间在哈比卜·塔默尔医院胃肠病科住院的慢性胰腺炎患者。

结果

本研究纳入了16例患者(平均年龄43岁,性别比为7)。所有患者在诊断时均有症状,上腹部疼痛是主要症状。12例患者在诊断时出现并发症:分别有5例和3例患者出现内分泌和外分泌胰腺功能衰竭,而其他并发症较少见:急性胰腺炎(2例)、胆汁淤积性黄疸(2例)和胰腺假性囊肿(2例)。62%的患者接受了内镜治疗,成功率为63%。37%的病例需要手术治疗。平均随访时间为16个月。一年生存率为93%。1例患者因低血糖死亡。本研究中未发现胰腺肿瘤。

结论

在内镜治疗慢性胰腺炎中,其作用显著,但并非没有一定风险。因此,外科医生和内镜医生之间需要合作,应根据个体情况考虑最佳治疗方案。

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