Laugier R, Renou C
Centre Hospitalier Régional, Hôpital de la Timone, Marseille, France.
Ital J Gastroenterol Hepatol. 1998 Oct;30(5):566-70.
Endoscopic treatment of chronic pancreatitis has drawn benefits from endoscopic procedures previously described for the main bile duct. Endotherapy is developing throughout the world. Cyst drainage procedures certainly represent the largest step forward in that non-surgical approach, whatever it is either direct (through the stomach or the duodenum) or indirect through the papilla in the duodenum. This procedure gives similar results to surgery with a lower morbidity. Pancreatic duct drainage associated with stone clearance is feasible and provides good results which have not yet been compared with those obtained thanks to surgery. Nonetheless, when the duct is not widely dilated it has been proven to be a satisfactory alternative to surgery. By contrast, chronic cholestasis does not appear to be a good indication of endotherapy.
慢性胰腺炎的内镜治疗受益于先前用于主胆管的内镜手术。内镜治疗在全球范围内不断发展。无论囊肿引流手术是直接的（通过胃或十二指肠）还是间接通过十二指肠乳头进行，它无疑是该非手术方法取得的最大进展。该手术与手术效果相似，但发病率较低。与结石清除相关的胰管引流是可行的，并且效果良好，但其效果尚未与手术取得的效果进行比较。尽管如此，当胰管未广泛扩张时，已证明它是手术的一种令人满意的替代方法。相比之下，慢性胆汁淤积似乎不是内镜治疗的良好适应证。
