经十二指肠镜分别放置胆胰管支架治疗复发性胆源性胰腺炎临床观察

Clinical Observation of Respective Insertion of Biliary and Pancreatic Stents by Duodenoscope in Treatment of Recurrent Biliary Pancreatitis

目的探讨经十二指肠镜分别放置胆胰管支架治疗复发性胆源性胰腺炎的临床效果。方法将2011年6月—2014年3月我院收治的93例复发性胆源性胰腺炎按治疗方法分为研究组48例和对照组45例,研究组经十二指肠镜置入胆胰管支架,对照组行腹腔镜胆囊切除术,观察两组术后情况及并发症。结果两组治愈率100%。研究组腹痛缓解时间、血清淀粉酶和肝功能恢复正常时间及平均住院时间较对照组明显缩短（P〈0.05,P〈0.01）。研究组2例出现黑便,给予对症治疗后症状消失。随访4~30个月,研究组无复发,对照组3例复发。结论经十二指肠镜置入胆胰管支架治疗复发性胆源性胰腺炎临床疗效满意,具有创伤小、住院时间短、复发率低的优点。

Objective To explore the clinical effect of biliary and pancreatic duct stents placed under duodeno- scope in treatment of recurrent biliary pancreatitis. Methods A total of 93 patients with recurrent gallstone pancreatitis during June 2011 and March 2014 were randomly divided into observation group （a = 48 ） and control group （n = 45 ）. The observation group was inserted with biliary and pancreatic duct stents under duodenoscope, while the control group was treated with laparoscopic cholecystectomy. The postoperative conditions and complications in the two groups were ob- served. Results The cure rates of the two groups were 100%. The relief time of abdominal pain, recovery time of serum amylase, recovery time of liver function and average length of hospital stay in observation group were significantly shorter than those in control group （P 〈 0. 05, P 〈 0.01 ）. Two patients in observation group had black stools, but the symptoms disappeared after symptomatic treatment. After 4-30 months of follow-up, no recurrence was found in observation group, while 3 patients had recurrence in control group. Conclusion The biliary and pancreatic duct stent under duodenoscope in treatment of recurrent biliary panereatitis may achieve satisfactory clinical effect with minimum trauma, shorten hospi- talization time with a low recurrence rate.