慢性胰腺炎的内镜治疗

慢性胰腺炎(CP)是一种进行性、不可逆性炎症疾病,可引起慢性腹痛、营养不良及其他并发症,药物、内镜、外科手术的治疗均很重要。内镜治疗可运用包括胰管括约肌切开术、支架置入、狭窄扩张、ESWL、取石、囊肿引流和超声内镜引导下的治疗等多种方法,为药物治疗失败及不适合外科手术的患者提供了治疗手段。本文对内镜治疗CP所致胆胰管结石及狭窄、胰漏、胰腺假性囊肿的效果进行了综述,对EUS引导下腹腔神经丛阻滞术治疗胰性疼痛也进行了讨论。

Endotherapy of chronic pancreatitis

Chronic pancreatitis is a irreversible and continuous inflammatory disease that can result in chronic abdominal pain,malnutrition,and other related complications.A multidisciplinary approach involving medical,endoscopic,and surgical therapy is important.Endotherapy can be performed with various combinations of pancreatic sphincterotomy,stent placement,stricture dilation,ESWL,stone removal,pseudocyst drainage,and EUS-guided access and therapy.Endoscopic therapy plays a specific role in carefully selected patients as primary interventional therapy when medical measures fail or in patients who are not suitable for surgery.This review addresses the role of endoscopic therapy in relief of obstruction of the pancreatic duct(PD) and bile duct,closure of PD leaks,and drainage of pseudocysts in CP.The role of endoscopic ultrasound-guided celiac plexus block for pain in chronic pancreatitis is also discussed.