Pancreas divisum.
Pancreas divisum.
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DOI：
10.1007/s11894-010-0170-8
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发表时间：
2011-04
影响因子：
--
通讯作者：
Wamsteker EJ
中科院分区：
文献类型：
--
作者：
DiMagno MJ;Wamsteker EJ
我们回顾了自2007年以来胰腺分裂（PD）的重要新临床观察结果。PD很常见，在一般人群和特发性胰腺炎（IP）中的患病率相同。高达53%的PD和IP患者患有基础特发性慢性胰腺炎（CP），在严格的前瞻性临床随访和/或自然史研究中，许多特发性复发性急性胰腺炎（IRAP）患者患有特发性CP。根据回顾性研究，PD不会改变非酒精性或酒精性CP的自然病程。CFTR和/或SPINK 1基因突变与IP（特发性CP和IRAP）相关，与PD的存在无关。超过三分之一的胰腺炎或假定胰胆疼痛患者对安慰剂有反应。非对照研究的作者报告了IP和PD患者对手术和内镜治疗的显著症状反应，但该反应尚未得到证实，并且主要限于IRAP患者，而不是特发性CP或慢性疼痛患者。
We review important new clinical observations in pancreas divisum (PD) made since 2007. PD is common and has the same prevalence in the general population and idiopathic pancreatitis (IP). Up to 53% of patients with PD and IP have underlying idiopathic chronic pancreatitis (CP), and in rigorous prospective clinical follow-up and/or natural history studies, many with idiopathic recurrent acute pancreatitis (IRAP) have idiopathic CP. According to retrospective studies, PD does not modify the natural course of nonalcoholic or alcoholic CP. CFTR and/or SPINK1 gene mutations associate with IP (idiopathic CP and IRAP) independently of the presence of PD. More than one third of patients with pancreatitis or presumed pancreaticobiliary pain respond to placebo. Authors of uncontrolled studies report a significant symptomatic response to surgery and endotherapy in patients with IP and PD, but the response remains unproven and is largely limited to those with IRAP and not idiopathic CP or chronic pain.