Sherman S, Lehman G A
Division of Gastroenterology/Hepatology, Indiana University Medical Center, Indianapolis, USA.
Gastroenterologist. 1997 Dec;5(4):262-77.
Endoscopic management of a variety of benign and malignant biliary tract diseases is now a well-established alternative to surgery. Similar techniques are now applied to the pancreas and are being used in the setting of acute pancreatitis, chronic pancreatitis, complications of pancreatitis, and pancreas divisum. This review analyzes the current state of the art of these exciting applications of endoscopy. Selection of appropriate candidates for the various treatment modalities appears important for optimal results of therapy. However, definite recommendations are difficult to make because there are limited controlled studies, follow-up in most series is brief, and there are no comparison studies of endoscopic versus surgical therapy. At present, careful case selection and conservatism are the appropriate general rule in these therapeutic endeavors. Further prospective random studies are awaited.
内镜治疗各种良性和恶性胆道疾病现已成为一种成熟的手术替代方法。类似的技术目前也应用于胰腺，用于急性胰腺炎、慢性胰腺炎、胰腺炎并发症及胰腺分裂症的治疗。本文综述分析了内镜这些令人振奋的应用的当前技术水平。为获得最佳治疗效果，选择适合各种治疗方式的患者似乎很重要。然而，由于对照研究有限，大多数系列研究的随访时间较短，且缺乏内镜治疗与手术治疗的比较研究，因此很难给出明确的建议。目前，在这些治疗工作中，谨慎的病例选择和保守治疗是合适的一般原则。期待进一步的前瞻性随机研究。
