胰腺液体积聚的消化内镜治疗研究进展

Research progress of gastroendoscopic treatment for pancreatic fluid accumulation

胰腺液体积聚(PFCs)是急性、慢性胰腺炎、外伤、肿瘤及手术引起胰腺损伤后的常见并发症。目前,消化内镜已成为治疗PFCs的优先方案。PFCs根据病程、是否形成成熟囊壁及内容物可分为4类。PFCs的内镜治疗方案取决于液体积聚的分类以及病灶与胰管的解剖结构,其中胰腺假性囊肿及包裹性坏死需要采取内镜治疗。常见的内镜术式包括经内镜逆行性胰胆管造影术、胰管支架置入、透壁引流术以及内镜下坏死组织清创术。内镜治疗PFCs的常见并发症包括支架移位/放置不当、出血、穿孔及空气栓塞。本研究对PFCs的分类、不同类型积聚的内镜治疗方式、不同的内镜术式及常见的并发症进行综述。

Pancreatic fluid collections(PFCs)are a common complication induced by pancreatic diseases including acute or chronic pancreatitis,trauma,tumor and surgery.Atpresent,digestive endoscopy has been preferentially utilized in the treatment of PFCs.PFCs can be divided into four categories according to the course,the existence of mature cystic walls and the contents of the PFCs.The method of endoscopic treatment depends on the classification of PFCs,lesions and anatomical structure of pancreatic duct.Endoscopic treatment options include pseudocyst and encapsulated necrosis of pancreas,their commonly used treatments involved in endoscopic retrograde cholangio pancreatography,stent placement of pancreatic duct transmural drainage and direct endoscopic necrosectomy.Common complications of endoscopic treatment of PFCs include stent displacement/improper placement,bleeding,perforation,and air embolism.This article reviewed the classification of PFCs,endoscopic treatments for different types of PFCs,options of endoscopic surgery and common complication of endoscopic operation.