内镜治疗慢性胰腺炎的探讨

目的 探讨内镜治疗慢性阻塞性胰腺炎疗效及并发症。方法 经内镜治疗２９例慢性胰腺炎中胰管括约肌切开术２７例（１９例为７内镜治疗前处置），副乳头切开８例，乳头括约肌切开术５例，网篮邓胰石９例，胰管内引流７例，鼻胰管引流３例，辅助探条或球囊扩张共１４例。１３例治疗前、后检测胰腺内分泌功能。结果 ２９例中２６例（８９．７％）治疗后腹痛消失或明显减轻，９例胰腺结石患者中６例取出胰石；７例胰管内引流管未阻塞。

Endoscopic management for chronic pancreatitis

Objective The efficacy of endoscopic treatment for chronic pancreatitis was studied.Methods 29 patients with chronic pancreatitis, received the therapy of endoscopy. Of the series 27 hadendoscopic pancreatic sphincterotomy (EPST) ,as a preceding treatment in 19 cases, 8 had minor papillotomy,6 subjected to endoscopic sphincterotormy (EST) . Pancreatic stones were extracted with basket (n = 9) andduct dilated with balloon or bougienage (n = 14) followed by pancreatic duct endoprothesis (PDE, n = 7) andnasal pancreatic drainage (NPD, n = 3). Pancreatic functions were tested before and after therapy (n = 13).Results Abdominal pain was eliminated or redcuced obviously in 26/29 (89.7%) cases. Pancreatic stonewas extracted successfully in 6/9 cases, no occlusion detected in 7 instances having PDE at the end of 6 weekswhen the prothesis was withdrawn. In 6 cases with abnormal glucose metabolism reexanmined with oral gluosetolerance test (75g O - GTF) and imnunoreactive insulin (IRI) test, it was found that one patient turned tonormal type from boardline type and one turned to boardline type from the abnormal. Acute panceratitis ensuedin 2 cases, infection of pancreatic fluid occured in 1. Abdominal pain recurred in 3 out of 18 followed up forone and half years. Conclusion Endoscopic management for chronic pancreatitis is relatively effective andsecure.