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[主胰管支架置入术治疗急性操作后胰腺炎]

[Stenting of the main pancreatic duct for acute post-manipulation pancreatitis].

作者信息

Zhdanov A V, Korymasov E A, Navasardyan N N

机构信息

Railway Clinical Hospital on Samara station, Samara, Russia.

Samara State Medical University of the Ministry of Health of Russia, Samara, Russia.

出版信息

Khirurgiia (Mosk). 2020(1):33-39. doi: 10.17116/hirurgia202001133.

Abstract

OBJECTIVE

To evaluate the results of stenting of the main pancreatic duct for acute post-manipulation pancreatitis.

MATERIAL AND METHODS

There were 946 transpapillary interventions within 5-year period. Various risk factors of this complication and the role of stenting of the main pancreatic duct for prevention of acute post-manipulation pancreatitis were analyzed for the same period. Complication was predicted only in some cases. There were 10 patients with unpredicted acute pancreatitis for this period. In all cases, an attempt of stenting of the main pancreatic duct was made in the first hours after development of complication. Stenting was successful in 7 cases. Technical success of operation was 70%. Stenting was followed by clinical improvement and pain relief.

RESULTS

The course of acute post-manipulation pancreatitis is milder in patients who underwent pancreatic stenting. There were no cases of purulent-necrotic complications in these patients (n=7). At the same time, 2 cases of pancreatic necrosis were observed in the control group. One patient died among those who did not undergo stenting of the pancreatic duct.

CONCLUSION

Stenting of the main pancreatic duct is effective in patients with acute post-manipulation pancreatitis. The course of acute post-manipulation pancreatitis is milder in patients who underwent pancreatic stenting. Significant clinical improvement is observed the next day after stenting. Stenting of the pancreatic duct should be carefully considered early after development of complication.

摘要

目的

评估主胰管支架置入术治疗急性操作后胰腺炎的效果。

材料与方法

5年期间共进行了946例经乳头介入操作。同期分析了该并发症的各种危险因素以及主胰管支架置入术在预防急性操作后胰腺炎中的作用。仅在部分病例中预测到了并发症。该期间有10例患者发生了意外的急性胰腺炎。在所有病例中,并发症发生后的最初数小时内均尝试对主胰管进行支架置入。7例成功置入支架。手术技术成功率为70%。支架置入后临床症状改善,疼痛缓解。

结果

接受胰管支架置入术的患者急性操作后胰腺炎病程较轻。这些患者(n = 7)未发生化脓性坏死性并发症。同时,对照组观察到2例胰腺坏死。1例未接受胰管支架置入术的患者死亡。

结论

主胰管支架置入术对急性操作后胰腺炎患者有效。接受胰管支架置入术的患者急性操作后胰腺炎病程较轻。支架置入术后第二天观察到明显的临床改善。并发症发生后应尽早仔细考虑胰管支架置入术。

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