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目的探讨内镜下胰管支架置入术治疗慢性胰腺炎的疗效和并发症。方法回顾性分析2005年3月～2010年3月在我院诊断的30例慢性胰腺炎患者,均在内镜逆行性胰胆管造影(ERCP)术后行胰管括约肌小切口,并置入胰管塑料支架。术后随访观察临床症状及生化检查等变化情况。结果 30例患者共放置胰管支架51例次,除2例支架自行脱落外,每例次支架留置时间为30 d～508 d,平均155 d。12例患者为多次放置。每个患者支架治疗时间平均9.25个月(1个月～25个月)。术后2例支架移位,2例发生ERCP术后轻症胰腺炎。30例患者随访28例,平均33.1个月(8个月～60个月),26例随访超过1年,14例超过3年。其中24例在支架移除后平均随访27.7个月(2个月～51个月)。在随访3个月时腹痛缓解率达92.8%(26/28),远期腹痛缓解率(>3年)为78.6%(11/14)。平均体重增加2.58 kg。结论胰管内支架置入术安全;对于慢性胰腺炎的治疗效果在支架取出后远期随访,发现患者仍能有效地缓解疼痛症状;临时胰管支架作为慢性胰腺炎内镜治疗的—部分有相当的临床成功概率,相当一部分病人不需要进—步的治疗。
Objective To investigate the efficacy and complications of endoscopic pancreatic duct stenting in the treatment of chronic pancreatitis. Methods A retrospective analysis of 30 patients with chronic pancreatitis diagnosed in our hospital from March 2005 to March 2010 was performed a small incision of pancreatic duct sphincter after endoscopic retrograde cholangiopancreatography (ERCP) Tube plastic bracket. Follow-up observation of clinical symptoms and biochemical tests and other changes. Results A total of 51 pancreatic duct stents were placed in 30 patients. The stent placement time was 30 days to 508 days (average, 155 days) except for 2 cases of spontaneous detachment. Twelve patients were placed multiple times. The average duration of stent treatment in each patient was 9.25 months (1 month to 25 months). Two cases were displaced after stenting, and 2 cases had mild pancreatitis after ERCP. Twenty-eight patients were followed up for an average of 33.1 months (ranged from 8 months to 60 months). Twenty-six patients were followed up for more than 1 year and 14 patients for more than 3 years. Of these, 24 were followed up for an average of 27.7 months (2 months to 51 months) after stent removal. Abdominal pain relief rate was 92.8% (26/28) at 3 months follow-up, and long-term abdominal pain relief rate (> 3 years) was 78.6% (11/14). The average weight gain was 2.58 kg. Conclusions Stent placement is safe. The long-term follow-up of chronic pancreatitis after long-term follow-up has found that patients can still effectively relieve the pain symptoms. The temporary pancreatic duct stents as a part of chronic pancreatitis endoscopically The probability of clinical success, a considerable number of patients do not need further treatment.