Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland.
United European Gastroenterol J. 2023 Nov;11(9):884-893. doi: 10.1002/ueg2.12466. Epub 2023 Oct 9.
Chronic Pancreatitis (CP) causes morphological changes in the pancreatic tissue, leading to complications and pain, which may require endoscopic interventions.
Our aim was to determine the frequency of endoscopic procedures (EP) in CP patients and to analyse pain and quality of life (QoL) in these patients after their EP.
This study included 1327 CP patients from the Scandinavian Baltic Pancreatic Club (SBPC) database including four countries and eight centres. We analysed patients undergoing EPs and gathered information on the EP, pancreatic function, pain, disease and duration. The EORTC C-30 QoL questionnaire was gathered prospectively and multivariable analysis was conducted on independent parameters between the groups. The reference population had no interventions (n = 870).
260 CP patients (22%) underwent EPs, median one year (range 0-39 years) after CP diagnosis. 68% were males. The median age was 59 (20-90) years. Most common aetiological factors were alcohol in 65% and smoking in 71%. Extracorporeal shock wave lithotripsy (ESWL) was used in 6% of the CP population and in 21% of the EP group. Biliary duct stenting was performed on 37% and pancreatic stenting was performed on 56% of the patients. There was no difference in pain patterns between patients who had pancreatic stenting and the reference population. The EP group had slightly better QoL (p = 0.047), functioning and fewer symptoms than the reference population, in the multivariable analysis there was no interaction effect analysis between the groups. The pancreatic stent group had better QoL and the same amount of pain than the reference group. The patients who needed later surgery (23%) had more pain (p = 0.043) and fatigue (p = 0.021).
One in five of the CP patients underwent EP. These patients scored higher on QoL responses and had better symptom scores. CP patients who had pancreatic stenting performed had the same pain patterns as the reference population. Randomised prospective trials are needed to determine the effect of endoscopy procedures on CP patients.
慢性胰腺炎（CP）会导致胰腺组织发生形态学改变，进而引发并发症和疼痛，这些可能需要内镜介入治疗。
我们旨在确定 CP 患者内镜治疗（EP）的频率，并分析这些患者 EP 后的疼痛和生活质量（QoL）。
本研究纳入了来自斯堪的纳维亚波罗的海胰腺俱乐部（SBPC）数据库的 1327 例 CP 患者，该数据库涵盖了四个国家和八个中心。我们分析了接受 EP 的患者，并收集了 EP、胰腺功能、疼痛、疾病和病程相关信息。前瞻性收集 EORTC C-30 QoL 问卷，并对组间独立参数进行多变量分析。参考人群未接受干预（n=870）。
260 例 CP 患者（22%）在 CP 诊断后 1 年中位数（范围 0-39 年）接受了 EP。68%为男性，中位年龄为 59（20-90）岁。最常见的病因因素是酒精占 65%，吸烟占 71%。体外冲击波碎石术（ESWL）在 CP 人群中的使用率为 6%，在 EP 组中的使用率为 21%。胆管支架置入术的使用率为 37%，胰腺支架置入术的使用率为 56%。在胰腺支架置入组和参考人群之间，疼痛模式没有差异。在多变量分析中，EP 组的 QoL（p=0.047）、功能和症状评分均略优于参考人群，但两组间无交互效应分析。胰腺支架组的 QoL 优于参考组，疼痛程度相同。需要后续手术的患者（23%）疼痛（p=0.043）和疲劳（p=0.021）程度更高。
五分之一的 CP 患者接受了 EP。这些患者的 QoL 评分更高，症状评分更好。接受胰腺支架置入术的 CP 患者的疼痛模式与参考人群相同。需要进行随机前瞻性试验来确定内镜治疗对 CP 患者的影响。
