Dite P, Zboril V, Cikankova E
3rd Medical Clinic of Gastroenterology, Teaching Hospital of Masaryk University, Brno Bohunice, Czech Republic.
Hepatogastroenterology. 1996 Nov-Dec;43(12):1633-7.
BACKGROUND/AIMS: Endoscopic therapy of chronic obstructive pancreatitis is an indubitable contribution to patients which brings immediate pain relief, enables an increased caloric food intake and improves the quality of patient's life. The authors describe their experience in a set of 42 subjects, in whom endoscopic papillotomy of the pancreatic duct was carried out after diagnosis of chronic obstructive pancreatitis.
Endoscopic papillotomy was performed in 42 patients. In 17 patients, papillotomy was followed by the drainage of the pancreatic duct.
The treatment led to disappearance or significant decrease of the epigastric pain in 85.7% patients shortly after the treatment; in 47.1% of patients the painless period lasted for further 24 months after the therapy. Increase in body weight of about 2 kg occurred in 53% of treated subjects during the 2 years since the therapy. Complications in treatment, such as acute pancreatitis in 3 patients and bleeding in 2 were mastered conservatively.
Endoscopic therapy of chronic pancreatitis is an alternative approach of managing the algic form of chronic obstructive pancreatitis. Changes in the area of Vater papilla, pathological content of pancreatic duct, structure or complications of chronic pancreatitis could be solved endoscopically with a minimum burden on patient. According to the experience of the authors, endoscopic papillotomy of pancreatic duct with contingent drainage led to the pain disappearence nearly in 50% of patients in the set of 42 subjects 24 months after the performance. This fact was followed with an increase in body weight in more than 50% of treated subjects. Minimum of complications put the endoscopic therapy among relatively safe and at the same time effective approach to chronic pancreatitis.
背景/目的：慢性阻塞性胰腺炎的内镜治疗对患者有着毋庸置疑的贡献，它能立即缓解疼痛，增加热量摄入，提高患者生活质量。作者描述了他们对42例患者的治疗经验，这些患者在被诊断为慢性阻塞性胰腺炎后接受了胰管内镜乳头切开术。
对42例患者进行了内镜乳头切开术。其中17例患者在乳头切开术后进行了胰管引流。
治疗后不久，85.7%的患者上腹部疼痛消失或显著减轻；47.1%的患者在治疗后无痛期持续了24个月。治疗后的2年中，53%的患者体重增加了约2千克。治疗中的并发症，如3例急性胰腺炎和2例出血，均通过保守治疗得到控制。
慢性胰腺炎的内镜治疗是治疗慢性阻塞性胰腺炎疼痛形式的一种替代方法。 Vater乳头区域的改变、胰管的病理内容物、慢性胰腺炎的结构或并发症都可以通过内镜解决，对患者的负担最小。根据作者的经验，在42例患者中，胰管内镜乳头切开术并适时引流在术后24个月使近50%的患者疼痛消失。这一结果伴随着超过50%的治疗患者体重增加。并发症最少使内镜治疗成为一种相对安全且有效的慢性胰腺炎治疗方法。
