摘要
慢性胰腺炎是胰腺组织的慢性炎症性和纤维化病变,主要表现为胰腺不可逆转的形态学改变和内、外分泌功能的永久持续丢失以及顽固性疼痛。发病机制不完全清楚,临床表现多样。主要治疗方法是缓解疼痛和提高生活质量,手术治疗是关键环节。理想的手术方案不仅需要缓解疼痛、引流胰管、治疗邻近器官梗阻性并发症,还需要最大可能保存胰腺的内、外分泌功能,保证生活质量和预防复发。手术方法主要包括引流胰管类、切除部分胰腺组织类、以及引流+切除联合三大类手术,其中保留十二指肠的胰头切除术逐渐成为治疗慢性胰腺炎的标准术式。本文就慢性胰腺炎的外科治疗策略作一评述。
Chronic inflammation and pancreatic fibrosis are the main pathological changes in chronic pancreatitis (CP), following irreversible morphological changes and toss of endocrine/exocrine function and intractable pain. The mechanism is not fully clear, and the clinical manifestation is multiple. Pain relief and improvement in the quality of life are of paramount importance for any intervention in chronic pancreatitis. Surgery is a critical option for CP. An optimal surgical intervention should manage mainly the intractable pain, resolve the complications of the adjacent organs and a- chieve the drainage of the main pancreatic duct. An optimal procedure should guarantee a low relapse rate, preserve a maximum of endocrine and exocrine function, and most importantly, restore quality of life. Operations mainly include drainage, resection, and hybrid procedure. According to the trials conducted so far, Duodenum-preserving resection of the pancreatic head offers the best short-term outcome. It combines the highest safety of all surgical procedures with the highest efficacy.
出处
《西部医学》
2016年第7期894-899,共6页
Medical Journal of West China
基金
国家自然科学基金(81401622)
关键词
慢性胰腺炎
外科
策略
Chronic pancreatitis
Surgery~ Strategy