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葡萄牙胰腺俱乐部慢性胰腺炎诊疗建议:内科、内镜及外科治疗(第二部分)

Clube Português do Pâncreas Recommendations for Chronic Pancreatitis: Medical, Endoscopic, and Surgical Treatment (Part II).

作者信息

Rodrigues-Pinto Eduardo, Caldeira Ana, Soares João Bruno, Antunes Teresa, Carvalho Joana Rita, Costa-Maia José, Oliveira Pedro, Azevedo Richard, Liberal Rodrigo, Bouça Machado Tiago, Magno-Pereira Vitor, Moutinho-Ribeiro Pedro

机构信息

Gastroenterology Department, Centro Hospitalar de São João, Porto, Portugal.

Gastroenterology Department, Hospital Amato Lusitano, Castelo Branco, Portugal.

出版信息

GE Port J Gastroenterol. 2019 Oct;26(6):404-413. doi: 10.1159/000497389. Epub 2019 Mar 28.

Abstract

Chronic pancreatitis (CP) is a complex disease that should be treated by experienced teams of gastroenterologists, radiologists, surgeons, and nutritionists in a multidisciplinary environment. Medical treatment includes lifestyle modification, nutrition, exocrine and endocrine pancreatic insufficiency correction, and pain management. Up to 60% of patients will ultimately require some type of endoscopic or surgical intervention for treatment. However, regardless of the modality, they are often ineffective unless smoking and alcohol cessation is achieved. Surgery retains a major role in the treatment of CP patients with intractable chronic pain or suspected pancreatic mass. For other complications like biliary or gastroduodenal obstruction, pseudocyst drainage can be performed endoscopically. The recommendations for CP were developed by Clube Português do Pâncreas (CPP), based on literature review to answer predefined topics, subsequently discussed and approved by all members of CPP Recommendations are separated in two parts: "chronic pancreatitis etiology, natural history, and diagnosis," and "chronic pancreatitis medical, endoscopic, and surgical treatment." This abstract pertains to part II.

摘要

慢性胰腺炎(CP)是一种复杂的疾病,应由经验丰富的胃肠病学家、放射科医生、外科医生和营养师团队在多学科环境中进行治疗。医学治疗包括生活方式改变、营养、纠正胰腺外分泌和内分泌功能不全以及疼痛管理。高达60%的患者最终将需要某种类型的内镜或手术干预进行治疗。然而,无论采用何种方式,除非戒烟戒酒,否则这些治疗往往无效。手术在治疗患有顽固性慢性疼痛或疑似胰腺肿块的CP患者中仍起着主要作用。对于其他并发症,如胆道或胃十二指肠梗阻,可通过内镜进行假性囊肿引流。CP的这些建议由葡萄牙胰腺俱乐部(CPP)制定,基于文献综述以回答预先确定的主题,随后由CPP的所有成员进行讨论并批准。建议分为两部分:“慢性胰腺炎的病因、自然史和诊断”以及“慢性胰腺炎的药物、内镜和手术治疗”。本摘要涉及第二部分。

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本文引用的文献

1
Chronic pancreatitis.慢性胰腺炎。
Nat Rev Dis Primers. 2017 Sep 7;3:17060. doi: 10.1038/nrdp.2017.60.
3
Surgical Treatment for Chronic Pancreatitis: Past, Present, and Future.慢性胰腺炎的外科治疗:过去、现在与未来
Gastroenterol Res Pract. 2017;2017:8418372. doi: 10.1155/2017/8418372. Epub 2017 Jul 27.
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Guidelines for the understanding and management of pain in chronic pancreatitis.慢性胰腺炎疼痛理解和管理指南。
Pancreatology. 2017 Sep-Oct;17(5):720-731. doi: 10.1016/j.pan.2017.07.006. Epub 2017 Jul 13.

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