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目的 探讨内镜下胰管支架置入术的适应证及疗效。方法 对中国人民解放军总医院2001-03～2003-03期间收治的9例慢性胰腺炎(3例伴胰管结石),1例急性复发性胰腺炎,4例胰腺癌,3例乳头腺瘤、癌患者,在内镜下行乳头括约肌切开13例,胰管取石2例,乳头腺瘤、癌切除3例,狭窄部扩张10例,置入胰管支架20例次,支架置留时间2周至8个月,平均3.43个月。结果 置入胰管支架后,有16例患者中上腹痛缓解,食欲增加,消化功能好转。胰腺炎患者取出支架后随访12～35个月,平均数26.17个月,7例上腹痛缓解无反复,有3例患者仍经常上腹痛。手术并发症:术后有3例发生血清淀粉酶、脂肪酸轻度升高,1例出现梗阻性黄疸。结论 胰管支架内引流术适应于慢性胰腺炎或肿瘤导致的胰管梗阻者,改善症状,疗效可靠,安全性较好。
Objective To investigate the indications and curative effects of endoscopic pancreatic duct stenting. Methods Nine cases of chronic pancreatitis (3 cases with pancreatic duct), 1 case of acute recurrent pancreatitis, 4 cases of pancreatic cancer, 3 cases of papillary adenoma, In the cancer patients, 13 cases underwent endoscopic sphincterotomy, 2 cases with pancreatic duct stones, 3 cases with papillary adenomas, 3 cases with cancer resection, 10 cases with stenosis and 20 cases with pancreatic duct stents. The stent placement time was 2 weeks 8 months, an average of 3.43 months. Results Into the pancreatic duct stent, 16 patients in the upper abdominal pain relief, increased appetite, digestive function improved. Patients with pancreatitis were followed up for 12 to 35 months after stent removal, with an average of 26.17 months. There was no recurrence of upper abdominal pain relief in 7 patients, and 3 patients often had upper abdominal pain. Surgical complications: 3 cases of postoperative serum amylase, fatty acid increased slightly, 1 case of obstructive jaundice. Conclusion Drainage of pancreatic duct stents is suitable for patients with pancreatic duct obstruction caused by chronic pancreatitis or tumor, and the symptoms are improved. The curative effect is reliable and the safety is good.