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目的探讨内镜下慢性胰腺炎(CP)的治疗。方法确诊的35例慢性胰腺炎患者,根据患者的不同情况,采用乳头括约肌切开(EST)、胰管括约肌切开(EPST)、胰管扩张、胰管取石、鼻胰管引流(ENPD)或胰管内支架植入(PS)等术式治疗。结果术后1年腹痛改善率为74.3%(26/35);腹泻改善率为50.00%(2/4);24例胰管狭窄伴胰管扩张者,其中4例患者扩张胰管恢复正常,有效率达70.83%(17/24);6例狭窄性十二指肠乳头炎、4例胆、胰管合流异常者术后2周后复查肝功能,全部恢复正常;术后亦无大出血、穿孔、胰腺炎,无严重胰、胆道感染。但术后6个月出现内支架脱落3例,占8.57%(3/35),支架移位4例占11.43%(4/35),1例导致十二指肠侧壁黏膜损伤。结论内镜下治疗慢性胰腺炎具有简单、有效、微创、可重复等优点,但也有不足之处,且本组病例尚少,有待积累资料,做进一步深入评价。
Objective To investigate the treatment of endoscopic chronic pancreatitis (CP). Methods 35 patients with chronic pancreatitis were enrolled in this study. EST, pancreatic duct sphincterotomy (EPST), pancreatic duct dilatation, pancreatic duct extraction, nasopharyngeal drainage (ENPD) or Pancreatic duct stenting (PS) and other surgical treatment. Results The improvement rate of abdominal pain at 1 year after operation was 74.3% (26/35). The improvement rate of diarrhea was 50.00% (2/4). Twenty-four patients with pancreatic duct stenosis and pancreatic dilator, of which 4 patients had normal pancreatic duct expansion, The effective rate was 70.83% (17/24); 6 cases of stenotic duodenal papillitis, 4 cases of bile duct and pancreatic duct anomalies were reviewed 2 weeks after the operation of liver function, all returned to normal; no postoperative hemorrhage, Perforation, pancreatitis, no serious pancreatic, biliary tract infections. However, there were 3 cases (8.57% (3/35)) of stent dislocation within 6 months after operation, 4 cases (11.43%) of stent displacement (4/35) and 1 case of duodenal mucosal injury. Conclusion Endoscopic treatment of chronic pancreatitis is simple, effective, minimally invasive, reproducible, but there are also shortcomings, and the group of patients is still small, yet to accumulate data for further in-depth evaluation.