| 外科术后胰瘘：消化内镜介入治疗的新战场 |
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| 引用本文： | 翟亚奇,柴宁莉,令狐恩强,李惠凯. 外科术后胰瘘：消化内镜介入治疗的新战场[J]. 中华胃肠内镜电子杂志, 2019, 6(2): 77-81. DOI: 10.3877/cma.j.issn.2095-7157.2019.02.007 |
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| 作者姓名： | 翟亚奇 柴宁莉 令狐恩强 李惠凯 |
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| 作者单位： | 1. 100853 北京,解放军总医院第一医学中心消化内科 |
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| 基金项目： | 国家重点研发计划项目(2016YFC1303600) |
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| 摘 要： | 外科术后胰瘘(POPF)是胰腺外科手术最常见的并发症,严重威胁患者的生命健康。目前,POPF的治疗尚缺乏规范化的治疗策略。消化内镜介入技术,如内镜引导下逆行胰管造影术(ERCP)下胰管括约肌切开术/胰管支架置入术,超声内镜(EUS)引导下引流术,已被用于POPF的治疗,并取得了令人满意的临床疗效。同外科手术相比,EUS引导下引流术通过微创内引流的方式,更有助于缩短痊愈和住院时间,降低医疗费用,以及提高患者生活质量,并有望成为POPF的一线治疗方式。此外,POPF的管理需要多学科(外科、内镜、放射介入等)的共同参与,密切配合。鉴于目前研究多为回顾性的病例报道,其临床应用价值及地位仍需高质量的前瞻性大样本的临床研究予以证实。
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| 关 键 词： | 内镜下逆行胰胆管造影 超声内镜 外科术后胰瘘 远端胰腺切除术 |
| 收稿时间： | 2019-04-08 |
Postoperative pancreatic fistula: A new indication for endoscopic intervention |
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| Yaqi Zhai,Ningli Chai,Enqiang Linghu,Huika Li. Postoperative pancreatic fistula: A new indication for endoscopic intervention[J]. Chinese Journal of Gastrointestinal Endoscopy (Electronic Edition), 2019, 6(2): 77-81. DOI: 10.3877/cma.j.issn.2095-7157.2019.02.007 |
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| Authors: | Yaqi Zhai Ningli Chai Enqiang Linghu Huika Li |
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| Affiliation: | 1. Department of Gastroenterology and Hepatology, The First Medical Center of The PLA General Hospital, Beijing 100853, China |
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| Abstract: | Postoperative pancreatic fistula (POPF) is the most common major adverse event of distal pancreatectomy (DP) with a significant morbidity and mortality(3%-45%). Currently, there has no established standard treatment strategy for POPF.Endoscopic intervention, including ERCP (pancreatic stenting and/or sphincterotomy) and EUS-guided drainage, has been primarily showed to be safe and feasible for patients with POPF.Compared with surgical approaches, EUS-guided drainage may contribute to a shorter hospital stay, rapider resolution, lower cost and higher quality of life, which is expected to be the first-line therapy.Meantime, management of POPF need multidisciplinary cooperation involving surgery, endoscopy, interventional radiology.However, given limitations of present studies, large prospective study focusing on assessing its efficacy, safety and cost-effectiveness, are further required, as well as comparative studies with other established approaches. |
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| Keywords: | Endoscopic Retrograde Cholangiopancreatography Endoscopic ultrasound Postoperative pancreatic fistula Distal pancreatectomy |
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