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慢性胰腺炎疼痛的外科治疗

Surgical treatment of pain in chronic pancreatitis.

作者信息

Skube Mariya E, Beilman Greg J

机构信息

Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA.

出版信息

Curr Opin Gastroenterol. 2018 Sep;34(5):317-321. doi: 10.1097/MOG.0000000000000460.

DOI:10.1097/MOG.0000000000000460
PMID:29901517
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6558956/
Abstract

PURPOSE OF REVIEW

Patients suffering from chronic pancreatitis often require surgical intervention to treat their disease. This review discusses surgical options as well as reviews current trends and research in the operative management of chronic pancreatitis.

RECENT FINDINGS

Relevant current topics in the field include the appropriate timing of surgery as well as the relative benefits of various procedures, particularly duodenum-preserving pancreatic head resection versus pancreaticoduodenectomy. Multiple studies have found that surgery earlier in the disease course results in improved outcomes. Furthermore, the recent literature reports similar outcomes of duodenum-preserving pancreatic head resection when compared with pancreaticoduodenectomy.

SUMMARY

It is important for treating clinicians to be well versed on the interplay of medical, endoscopic, and surgical strategies to carefully tailor a patient's treatment plan. Each patient warrants careful consideration and an individualized approach in collaboration with multidisciplinary colleagues.

摘要

综述目的

慢性胰腺炎患者常需手术干预来治疗疾病。本综述讨论手术选择,并回顾慢性胰腺炎手术治疗的当前趋势和研究。

最新发现

该领域当前的相关主题包括手术的合适时机以及各种手术的相对益处,尤其是保留十二指肠的胰头切除术与胰十二指肠切除术的比较。多项研究发现,在疾病进程早期进行手术可改善预后。此外,近期文献报道保留十二指肠的胰头切除术与胰十二指肠切除术的预后相似。

总结

治疗临床医生熟悉医学、内镜和手术策略之间的相互作用,以精心制定患者的治疗方案非常重要。每位患者都需要仔细考虑,并与多学科同事合作采取个体化方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7846/6558956/e84d418ec500/nihms-1031775-f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7846/6558956/e84d418ec500/nihms-1031775-f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7846/6558956/e84d418ec500/nihms-1031775-f0001.jpg

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Turkish Gastroenterology Association, Pancreas Study Group, Chronic Pancreatitis Committee Consensus Report.

本文引用的文献

1
Total Pancreatectomy With Intraportal Islet Autotransplantation as a Treatment of Chronic Pancreatitis in Patients With CFTR Mutations.全胰切除术联合门静脉内胰岛自体移植治疗携带CFTR突变的慢性胰腺炎患者
Pancreas. 2018 Feb;47(2):238-244. doi: 10.1097/MPA.0000000000000968.
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Efficacy of Endotherapy in the Treatment of Pain Associated With Chronic Pancreatitis: A Systematic Review and Meta-Analysis.内镜治疗在慢性胰腺炎相关疼痛治疗中的疗效:一项系统评价和荟萃分析。
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土耳其胃肠病学协会胰腺研究组慢性胰腺炎委员会共识报告
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慢性胰腺炎行胰十二指肠切除术与保留十二指肠胰头切除术的对比:多中心、随机、对照、双盲 ChroPac 试验。
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Lancet. 2017 Sep 9;390(10099):1007-1008. doi: 10.1016/S0140-6736(17)32338-3.
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Operative management of chronic pancreatitis: A review.慢性胰腺炎的手术治疗:综述
Am J Surg. 2017 Aug;214(2):347-357. doi: 10.1016/j.amjsurg.2017.03.004. Epub 2017 Mar 14.
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Surgical strategies in the treatment of chronic pancreatitis: An updated systematic review and meta-analysis of randomized controlled trials.慢性胰腺炎治疗中的手术策略:随机对照试验的最新系统评价与荟萃分析
Medicine (Baltimore). 2017 Mar;96(9):e6220. doi: 10.1097/MD.0000000000006220.
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Total Pancreatectomy With Islet Autotransplantation Resolves Pain in Young Children With Severe Chronic Pancreatitis.全胰切除术联合胰岛自体移植可缓解重度慢性胰腺炎患儿的疼痛。
J Pediatr Gastroenterol Nutr. 2017 Mar;64(3):440-445. doi: 10.1097/MPG.0000000000001314.
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Comparative Efficacy of Bilateral Thoracoscopic Splanchnicectomy for Intractable Pain Secondary to Pancreatic Cancer vs Chronic Pancreatitis.双侧胸腔镜内脏神经切除术治疗胰腺癌与慢性胰腺炎继发顽固性疼痛的疗效比较
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Endoscopic vs. Surgical Interventions for Painful Chronic Pancreatitis: What is Needed for Future Clinical Trials.内镜治疗与手术治疗对疼痛性慢性胰腺炎的疗效比较:未来临床试验的需求
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