Endoscopic pancreatic duct drainage and stenting for acute pancreatitis and pancreatic cyst and abscess
Endoscopic pancreatic duct drainage and stenting for acute pancreatitis and pancreatic cyst and abscess
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DOI：
10.1007/s00534-006-1203-4
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发表时间：
2007-11-01
期刊：
影响因子：
--
通讯作者：
Koyama, Isamu
中科院分区：
文献类型：
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作者：
Shinozuka, Nozomi;Okada, Katsuya;Koyama, Isamu
背景/目的。经乳头和经壁入路的胰腺假性囊肿内镜引流已有报道。本研究对急性胰腺炎合并假性囊肿和脓肿患者行内镜下鼻胰管引流术（ENPD）和胰腺支架置入术，探讨其有效性和存在的问题。对13例胰腺炎合并与主胰管相通的假性囊肿或脓肿行内镜逆行胰管造影后，行ENPD和/或胰管支架置入术。ENPD在7名患者中进行，并在所有5名囊肿患者中有效：囊肿消失或缩小。然而，两名脓肿患者的病情没有变化，并进行了经皮引流。6例患者行支架植入术，6例囊肿消失或胰腺炎改善。两例患者的支架被移除，但迄今为止没有发现复发。ENPD和支架植入术是治疗急慢性胰腺炎和假性囊肿的有效选择，在避免胰瘘方面上级经皮引流，但对胰腺脓肿可能无效。治疗方法的选择应根据具体情况而定。
Background/Purpose. Endoscopic drainage of pancreatic pseudocysts using transpapillary and transmural approaches has been reported. In this study, endoscopic nasopancreatic drainage ( ENPD) and pancreatic stenting were performed in patients with pseudocyst and abscess associated with acute pancreatitis, and the usefulness and problems of the procedures were investigated.Methods. After endoscopic retrograde pancreatography was done, ENPD and/or pancreatic stenting were performed in 13 patients with pancreatitis and pseudocyst or abscess that communicated with the main pancreatic duct.Results. ENPD was performed in seven patients, and was effective in all five patients with cysts: the cysts disappeared or shrank. However, the condition in the two patients with abscess was unchanged, and percutaneous drainage was performed. Stenting was carried out in six patients, and the cyst disappeared or pancreatitis was improved in all six. The stent was removed from two patients, but no recurrence has been noted so far.Conclusions. ENPD and stenting are effective therapeutic choices for acute and chronic pancreatitis and pseudocysts, and they are superior to percutaneous drainage to avoid pancreatic fistula, but they may not be effective for pancreatic abscess. Selection of therapeutic methods corresponding to individual cases is important.