ERCP在不明原因复发性急性胰腺炎诊治中的作用

目的探讨ERCP在不明原因复发性急性胰腺炎(RAP)诊治中的作用。方法收集15例不明原因RAP患者。其中男5例,女10例,年龄25～65岁,中位年龄38岁,病程1～2年,发病次数2～5次。10例在急性发作期,5例在发作间期行ERCP诊治。结果15例患者经ERCP明确病因者6例(3例胆管微结石,1例胆总管末端小囊肿,1例胰管小结石,1例胰管蛋白栓子),可疑病因者6例(乳头旁憩室2例,十二指肠乳头炎4例),未明确病因者3例。根据ERCP检查结果,9例行乳头括约肌切开术(EST),6例行胰管括约肌切开术。术后随访2年,15例患者均未复发胰腺炎。ERCP和EST术后2例出现一过性高淀粉酶血症,无其他并发症。结论ERCP对不明原因RAP有明确病因和指导治疗的作用。

Diagnostic and therapeutic value of endoscopic retrograde cholangiopancreatography (ERCP) on idiopathic recurrent acute pancreatitis

Objective To evaluate the role of endoscopic retrograde cholangiopancreatography(ERCP) on idiopathic recurrent acute pancreatitis.Methods 15 patients with idiopathic recurrent acute pancreatitis were enrolled in this study,there were 5 males and 10 females,age between 25 and 65 with median age 38,duration between 1 and 2 years,recurrence between 2 and 5 times.All patients were treated by ERCP,ten of whom underwent ERCP during the acute attacks,and five of whom underwent ERCP after the acute attacks.Results The causes of recurrent pancreatitis were determined in six patients(3 biliary microlithiasis,1 choledochocyst,1 pancreatic duct stone,1 pancreatic duct protein embolus).The possible causes of recurrent pancreatitis were found in other 6 patients(2 diverticulum around duodenal papilla,4 duodenal papillitis).3 patients' causes were not determined.9 patients were treated by endoscopic bile duct papilla sphincterotomy(EST),and the others by endoscopic pancreatic duct papilla sphincterotomy according to the diagnosis of ERCP,no serious complications occurred after ERCP and EST,only 2 patients experienced hyperamylasemia.All 15 patients have no recurrence after two years follow-up.Conclusions ERCP can diagnose and treat idiopathic recurrent acute pancreatitis in some patients.