Sherman S, Hawes R H, Savides T J, Gress F G, Ikenberry S O, Smith M T, Zaidi S, Lehman G A
Department of Medicine, Indiana University School of Medicine, Indiana University Medical Center, Indianapolis 46202-5000, USA.
Gastrointest Endosc. 1996 Sep;44(3):276-82. doi: 10.1016/s0016-5107(96)70164-5.
Polyethylene pancreatic duct stents induce morphologic changes of the pancreatic duct in the majority of patients. This study was undertaken to determine if parenchymal abnormalities are present in patients undergoing short-term pancreatic duct stenting and to correlate these findings with the pancreatogram obtained at stent removal.
Twenty-five patients underwent pancreatic duct stenting and had an endoscopic ultrasound evaluation of the pancreas at stent removal. The pancreatograms were evaluated at stent removal for ductal irregularity, narrowing, and side branch changes. Endoscopic ultrasound was used to assess for differences in the echo characteristics of the pancreatic parenchyma around the stent compared with the rest of the gland.
Of the 16 patients evaluated by ERCP at stent removal, 9 (56%) had 1 or more new ductographic changes. Endoscopic ultrasound identified parenchymal changes in the stented region in 17 of 25 patients (68%). Four patients who had parenchymal changes in the stented region on endoscopic ultrasound at stent removal had a follow-up study at a mean time of 16 months. Two patients had (new) changes suggestive of focal chronic pancreatitis in the stented region.
Short-term pancreatic duct stenting induced both ductal and parenchymal changes in more than 50% of patients. Chronic pancreatitis may be a consequence of pancreatic duct stenting.
聚乙烯胰管支架在大多数患者中会引起胰管形态改变。本研究旨在确定接受短期胰管支架置入的患者是否存在实质异常，并将这些发现与支架取出时获得的胰管造影结果相关联。
25例患者接受了胰管支架置入，并在支架取出时接受了胰腺的内镜超声评估。在支架取出时评估胰管造影的导管不规则、狭窄和侧支变化。与腺体其余部分相比，内镜超声用于评估支架周围胰腺实质回声特征的差异。
在支架取出时接受内镜逆行胰胆管造影（ERCP）评估的16例患者中，9例（56%）有1项或更多新的胰管造影改变。内镜超声在25例患者中的17例（68%）发现支架置入区域有实质改变。4例在支架取出时内镜超声显示支架置入区域有实质改变的患者在平均16个月时进行了随访研究。2例患者在支架置入区域有提示局灶性慢性胰腺炎的（新）改变。
超过50%的患者短期胰管支架置入会引起导管和实质改变。慢性胰腺炎可能是胰管支架置入的后果。
