Endoscopic treatment of chronic pancreatitis:: A multicenter study of 1000 patients with long-term follow-up
Endoscopic treatment of chronic pancreatitis:: A multicenter study of 1000 patients with long-term follow-up
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DOI：
10.1055/s-2002-34256
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发表时间：
2002-10-01
期刊：
影响因子：
9.3
通讯作者：
Soehendra, N
中科院分区：
文献类型：
--
作者：
Rösch, T;Daniel, S;Soehendra, N
背景与研究目的：内镜下导管减压治疗已成为治疗疼痛性阻塞性慢性胰腺炎的一种成熟方法。规模较小的系列，大多有中期后续期，报告了令人鼓舞的结果。本分析提供了一个大型多中心患者队列的长期随访数据。患者和方法：在8个不同的中心接受内镜治疗的疼痛性慢性胰腺炎和因狭窄和/或结石引起的导管梗阻患者在2 - 12年后（平均4.9年）进行随访。从图表中记录患者的临床资料、技术成功率和并发症。采用结构化问卷前瞻性地获得随访数据；评估治疗成功的主要参数是疼痛的显著减轻（无疼痛或只有轻微疼痛）。结果：随访数据来自1211例患者中的1018例（84%），主要为狭窄（47%）、结石（18%）或狭窄合并结石（32%）。在长期随访中，60%的患者完成了内窥镜治疗，16%的患者仍在接受某种形式的内窥镜治疗，24%的患者接受了手术。在整个组中，内皮治疗的长期成功率为86%，但在意向治疗分析中只有65%。两组患者在狭窄、结石或两者都有方面没有显著差异。内镜治疗对胰腺功能无积极影响。结论：内镜下导管减压治疗作为唯一的治疗方式，可以缓解三分之二患者的疼痛。四分之一的病人必须接受手术。
Background and Study Aims: Endoscopic ductal decompression therapy has become an established method of treating patients with painful obstructive chronic pancreatitis. Smaller series, mostly with a medium-term follow-up period, have reported encouraging results. The present analysis presents long-term follow-up data from a large multicenter patient cohort.Patients and Methods: Patients with painful chronic pancreatitis and with ductal obstruction due to either strictures and/or stones treated encloscopically at eight different centers underwent follow-up after 2 - 12 years (mean 4.9 years). The patients' clinical data, the rate of technical success, and complications were recorded from the charts. Follow-up data were prospectively obtained using structured questionnaires; the main parameter for evaluating treatment success was a significant reduction in pain (no pain or only weak pain).Results: Follow-up data were obtained from 1018 of 1211 patients treated (84%) with mainly strictures (47%), stones (18%), or strictures plus stones (32%). At the long-term follow-up, 60% of the patients had their endotherapy completed, 16% were still receiving some form of endoscopic treatment, and 24% had undergone surgery. The long-term success of endotherapy was 86% in the entire group, but only 65% in an intention-to-treat analysis. There were no significant differences between the patient groups with regard to either strictures, stones, or both. Pancreatic function was not positively affected by endoscopic therapy.Conclusions: Endoscopic ductal decompression therapy offers relief of pain in two-thirds of the patients when it is used as the only form of treatment. One-quarter of the patients have to undergo surgery.