内镜治疗慢性胰腺炎的优势与局限性

Endotherapy for chronic pancreatitis： advantages and limi- tations

慢性胰腺炎的特征性病理改变为胰腺组织进行性纤维化，临床治疗目标包括缓解腹痛症状及延缓胰腺内、外分泌功能减退。内镜治疗慢性胰腺炎（逆行胰胆管造影术、体外震波碎石术和超声内镜等）创伤小，对慢性胰腺炎并发胰管结石、狭窄、胰腺假性囊肿及继发胆道梗阻安全有效，已部分替代外科手术，成为首选治疗方式之一。无论单纯内镜或是外科治疗慢性胰腺炎均有其局限性，因此，需要内科、外科、内镜、麻醉以及营养等多学科合作，制订最佳方案，提高患者生命质量。

Chronic pancreatitis （CP） is pathologically characterized by fibrosis of pancreatic parenchyma. Treatment of CP is to alleviate pain and preserve pancreatic endo-/exo-crine function. Endotherapy, as a micro-invasive method, has been testified to be efficient and safe for pancreatic duct stones and stenosis, pancreatic pseudocyst and common bile duct stenosis secondary to CP. It has partially replaced the role of surgery in CP therapy. Whether endoscopic or surgical treatment has its limitations, CP treatment needs medicine, surgery, endoscopy, anesthesia, nutrition and other disciplines together to develop the best solution to improve the quality of life.