治疗性经内镜逆行胰胆管造影在慢性胰腺炎患者中的应用

A clinical study of endoscopic retrograde cholangiopancreatography in treatment of chronic pancreatitis

目的探讨治疗性经内镜逆行胰胆管造影(ERCP)在慢性胰腺炎(CP)治疗中的价值。方法对2008年1月-2012年12月间在南京医科大学附属苏州市立医院应用ERCP治疗的30例CP患者进行回顾性分析。观察术前及术后24h血淀粉酶变化,动态观察患者治疗前后腹痛缓解情况,随访脂肪泻、焦虑患者病情,定期复查腹部影像学或ERCP明确胰腺病变及胰管支架情况。结果所有患者均顺利完成ERCP并放置胰管支架,术后72 h腹痛缓解率83.3%,1例因症状改善不明显至外科手术,术后病死率为0。结论 ERCP是治疗CP的有效手段,具有安全、有效、创伤小等优点。

Objective To explore the value of endoscopic retrograde cholangiopancreatography （ERCP）in the treatment of chronic pancre-atitis （CP）.Methods Thirty patients with CP who underwent ERCP from January 2008 to December 2012 were retrospectively analyzed. Serum amylase levels were determined before and at 24 hours after surgery.The reduction in abdominal pain was dynamically evaluated be-fore and after treatment.A follow -up of patients with steatorrhea and anxiety was performed.Regular reexamination using abdominal ima-ging or ERCP was performed to identify pancreatic lesions and conditions of pancreatic duct stents.Results All patients were successfully treated by ERCP and had pancreatic duct stents placed.The remission rate of abdominal pain reached 83.3% at 72 hours after surgery.One patient was assigned to surgery due to insignificant improvement in symptoms,and the case -fatality rate after surgery was 0.Conclusion ERCP is an effective method in the treatment of CP,which has the advantages of being safe,effective,and minimally invasive.