超声内镜辅助诊断胃窦异位胰腺与指导选择最佳治疗方案26例分析

Endoscopy ultrasonography for diagnosed 26 heterotopic pancreas

目的探讨超声内镜对异位胰腺的诊断与指导选择内镜下最佳治疗方案套扎联合高频电切除术、内镜下黏膜切除术(EMR)、内镜下黏膜剥离术(ESD)的临床应用价值。方法 2008年8月～2010年5月该院诊断异位胰腺患者26例,均先行超声内镜检查明确病变来源、范围及周边情况后再根据患者具体情况选择实施最适合患者的内镜下治疗方案。结果 7例选择套扎联合高频电切除术治疗的患者均完整切除病灶,未发生严重并发症,无复发;8例选择EMR治疗,2例复发,均未出现严重并发症;11例选在ESD治疗,均完整切除病灶,无复发,穿孔1例,活动性出血4例。结论超声内镜辅助诊断异位胰腺并指导选择内镜下最佳治疗方案是一种可靠、简洁、高效的方法,可在术前为操作者提供最可靠的信息,从而选择治疗方案,大大降低了治疗费用,减轻了患者痛苦。

[Objective] To explore the clinical value of diagnosis and choose the best treatment plan（ligation combined high frequent electricity,EMR,ESD） of heterotopic pancreas by EUS.[Methods] 26 heterotopic pancreas cases were diagnosed by endoscopy in our hospital from 2008.8-2010.5,and the best treatment plan was selected after the source and range detected by EUS.[Results] 7 cases of heterotopic pancreas were treated by high frequency electroresection after ligation,all cases were successfully and no complications occurred.8 cases were treated by EMR,no complications,but 2 cases recurred.11 cases were treated by ESD,no complications and no recurrence,1 case perforated,4 cases occurred active bleeding.[Conclusions] EUS is a reliable,convenient,effective method,which could auxiliary diagnose and chose the best treatment plan,degrade therapy cost and relieve distress of patients.