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慢性胰腺炎的实际管理:2016年在曼彻斯特举行的英国和爱尔兰胰腺学会年会上举办的多学科研讨会

The Practical Management of Chronic Pancreatitis: A Multidisciplinary Symposium Held at the Annual Meeting of the Pancreatic Society of Great Britain and Ireland, Manchester 2016.

作者信息

Jegatheeswaran Santhalingam, Puleston Joanne M, Duggan Sinead, Hart Andrew, Conlon Kevin C, Siriwardena Ajith K

机构信息

Hepato-Pancreato-Biliary Unit, Manchester, United Kingdom.

Department of Gastroenterology Manchester Royal Infirmary, Manchester, United Kingdom.

出版信息

Dig Surg. 2019;36(1):41-45. doi: 10.1159/000486399. Epub 2018 Jan 16.

Abstract

AIM

This study is about a questionnaire survey of delegates attending the chronic pancreatitis symposium at the 2016 meeting of the Pancreatic Society of Great Britain and Ireland and seeks a multidisciplinary "snapshot" overview of practice.

METHODS

A questionnaire was developed with multidisciplinary input. Questions on access to specialist care, methods of diagnosis and treatment including specific scenarios were incorporated. Eighty-three (66%) of 125 delegates effectively participated in this survey.

RESULTS

Twenty-four (29%) had neither a chronic pancreatitis MDT in their hospital nor a chronic pancreatitis referral MDT. Most frequently utilised diagnostic modalities were CT, MR and EUS with no respondents utilising duodenal intubation tests. Initial treatment was provided through non-opiate analgesia by 69 (93%), through the use of opiates by 56 (76%) and through the use of co-analgesics by 49 (66%). Fifty two (68%) routinely referred patients with alcohol-related disease for counselling. Preferred treatment for large duct disease without mass was endoscopic therapy. In older patients with a mass, pancreaticoduodenectomy was preferred.

CONCLUSION

This is a small study likely to be skewed by sampling bias but is thought to be the first multidisciplinary survey of the management of chronic pancreatitis in the United Kingdom and Ireland. The results show a need for comprehensive access to specialist pancreatitis MDT care and there remains substantial variation in management.

摘要

目的

本研究是关于对参加2016年英国和爱尔兰胰腺学会会议慢性胰腺炎研讨会的代表进行问卷调查,旨在获取多学科的实践“快照”概述。

方法

在多学科参与下编制了一份问卷。纳入了关于获得专科护理、诊断和治疗方法(包括特定情况)的问题。125名代表中有83名(66%)有效参与了本次调查。

结果

24名(29%)受访者所在医院既没有慢性胰腺炎多学科诊疗团队(MDT),也没有慢性胰腺炎转诊MDT。最常使用的诊断方式是CT、磁共振成像(MR)和超声内镜检查(EUS),没有受访者使用十二指肠插管检查。69名(93%)受访者最初通过非阿片类镇痛药进行治疗,56名(76%)通过使用阿片类药物治疗,49名(66%)通过使用辅助镇痛药治疗。52名(68%)受访者常规为酒精相关疾病患者提供咨询服务。对于无肿块的大导管疾病,首选治疗方法是内镜治疗。对于有肿块的老年患者,首选胰十二指肠切除术。

结论

这是一项规模较小的研究,可能存在抽样偏差导致结果有偏差,但被认为是英国和爱尔兰首次对慢性胰腺炎管理进行的多学科调查。结果表明需要全面获得专科胰腺炎MDT护理,并且管理方面仍存在很大差异。

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