15例慢性胰腺炎诊治经验

目的探讨慢性胰腺炎的治疗方案及效果。方法回顾分析2007~2012年我院收治的15例慢性胰腺炎患者的临床资料,总结各自接受的治疗方案和效果。结果手术治疗12例,内科治疗3例。9例行胰管切开取石,胰管空肠Roux-en-y吻合;2例行胆管空肠Roux-en-y吻合;1例行胰体尾部切除加脾脏切除术。7例术后疼痛症状完全缓解,5例手术后糖尿病症状得以缓解;其中2例特发性慢性胰腺炎患者,术后腹痛症状完全缓解且分别在术后2个月和4个月时完全停用胰岛素。1例术后6个月时发现为胰腺癌。结论慢性胰腺炎应遵循个体化治疗原则,手术方式应该以简单安全和缓解患者临床症状为前提,对于肿块型的慢性胰腺炎要尽量行肿块的切除。

Experiences of diagnosis and treatment for chronic pancreatitis - a report of 15 cases

Objective To explore the diagnosis and treatment for chronic pancreatitis. Methods The clinical data of 15 chronic pancreatitis patients in our hospital from 2007 to 2012 were retrospectively analyzed. Results There were 12 patients who received operation, pancreatolithotomy plus pancreaticojejunostomy performed in 9 of them, cholangiojejunostomy in 2, and resection of the body and tail of pancreas plus splenectomy in 1. All 15 patients were cured, with complete relief of intractable abdominal pain in 7 patients, blood glucose were partly cured in 5 patients, and insulin were freed from 2 18 -year -old female patients 2 and 4 months after operation. One patient was diagnosed with pancreatic cancer 6 months postoperation. Conclusion For patients with chronic pancreatitis, treatment should be individualized. Surgical treatment should be safe and simple based on the relief of the clinical symptoms firstly, and surgical treatment should be neces- sary when inflammatory mass is found at early phase.