内窥镜逆行胰胆管造影术对胰腺分裂症的诊断、治疗价值研究

Value of endoscopic retrograde cholangio-pancreatography in diagnosis and treatment of pancreatic divisum

目的:探讨内窥镜逆行胰胆管造影术(ERCP)对胰腺分裂症(PD)的诊断、治疗方法及其效果的价值。方法:回顾性分析本院2008年6月至2012年9月明确诊断的20例PD患者的临床表现、诊断及治疗方法,比较治疗前后患者的体重变化,用直观模拟标度尺(VAS)评分来评估腹痛症状改善的情况。结果:患者症状以腹痛为主,急性胰腺炎或慢性胰腺炎急性发作的发生率为75%。经ERCP确诊的患者中,磁共振胆胰管成像(MRCP)的检出率为24%。内镜下治疗包括行内镜下十二指肠主和(或)副乳头切开引流(95%)、胰管支架置入(65%)及鼻胰管引流(55%)。治疗后患者体重增加(P<0.05),疼痛VAS评分下降(P<0.05)。结论:PD患者主要症状为腹痛,急性胰腺炎或慢性胰腺炎急性发作的发生率较高,内镜下治疗可有效减少PD患者腹痛的程度并增加患者体重。

Objective To study the value of endoscopic retrograde cholangio-pancreatography （ERCP） in diagnosis and treatment of pancreatic divisum （PD）. Methods A retrospective analysis of clinical manifestations, diagnosis and treatment of 20 patients with pancreatic divisum from June 2008 to September 2012 was performed. Body weight and severity of pain assessed by visual analogue scale （VAS） were recorded before and after treatment. Results Abdominal pain was the main symptom; 75% patients had acute pancreatitis or acute occurrence of chronic pancreatitis. All patients were diagnosed by ERCP; the detection rate of magnetic resonance cholangiopanereatography （MRCP） was 24%. The patients were treated by endoscopy, including endoscopic major （or minor） papilla sphincterotomy （95%）, pancreatic duct stent placement （65%） and nasopanereatic drainage （55%）. After treatment, the body weight increased （P〈0.05）, and VAS pain score decreased （P〈0.05）. Conclusions Abdominal pain was the main symptom in PD patient,and the incidence of acute pancreatitis or acute occurrence of chronic pancreatitis was higher. Endoscopic treatment can relieve abdominal pain and increase body weight in patients with pancreatic divisum.