胰管支架预防全覆膜金属支架治疗良性胆管狭窄术后急性胰腺炎  

Pancreatic stent in prevention of postoperative acute pancreatitis in patients with benign biliary stricture treated by full-covered serf-expanding removable metal stents

作　　者：张诚 胡海[1] 张洪威[2] 杨玉龙 林美举[2] 赵刚[1] 马跃峰[2] Zhang Cheng, Hu Hai, Zhang Hongwei, Yang Yulong, Lin Meiju, Zhao Gang, Ma Yuefeng(Cholelithiasis Center,Tongfi University Affiliated Shanghai East Hospital, Shanghai 200120, China)

机构地区：[1]同济大学附属东方医院胆石病中心,上海200120 [2]大连大学附属中山医院胆石病微创外科

出　　处：《中华普通外科杂志》2018年第9期725-728,共4页Chinese Journal of General Surgery

摘　　要：目的探讨内镜逆行胰胆管造影置人胰管支架预防全覆膜自膨式可回收金属支架（FCSERMS）治疗良性胆管狭窄术后急性胰腺炎的临床价值及安全性和有效性。方法2011年1月至2016年12月共收治符合纳入标准的良性胆管狭窄患者92例．分为胰管支架组和对照组，观察FCSERMS置人及取出术后急性胰腺炎（AP）、高淀粉酶血症（HP）等胰腺炎损伤情况。结果胰管支架组55例、对照组37例。两组均成功置人FCSERMS，术后淀粉酶上升率及HP发生率差异均无统计学意义（23．6％比32．4％、3．6％比10．8％，均P〉0．05），术后AP发生率及一般淀粉酶升高率差异均有统计学意义（0比13．5％，20．0％比8．1％，均P〈0．05）。FCSERMS平均留置7．84±1．22个月，取出FCSERMS及胰管支架后两组淀粉酶升高率、AP及HP发生率、一般淀粉酶升高发生率差异均无统计学意义（3．6％比14．3％、0比2．9％、0比2．9％、3．6％比8．6％。均P〉0．05）。结论放置胰管支架可以预防内镜逆行胰胆管造影置入FCSERMS治疗良性胆管狭窄术后胰腺炎。Objective To investigate the clinical value, safety and efficacy of pancreatic stent in prevention of postoperative acute pancreatitis in patients with benign biliary stricture （BBS） treated by full-covered self-expanding removable metal stents （FCSERMSs）. Methods From Jan 2011 to Dec 2017, 92 BBS patients who met the inclusion criteria were admitted and divided into pancreatic stent （PS） group and control group. The acute pancreatitis （AP） and hyperamylase （HP） after FCSERMS implantation and removal was observed. Results 55 cases in PS group and 37 cases in control group underwent successful FCSERMS implantation. The incidences of postoperative elevated amylase and HP had no significant differences between the two groups （23.6% vs. 32.4%, 3.6% vs. 10. 8% ,all P 〉0. 05）. The incidences of postoperative AP and moderately elevated amylase had significant differences （0 vs. 13.5% ,20. 0% vs. 8. 1% , all P 〈 0. 05 ）. The average placement time of FCSERMSs was 7.84 ~ 1.22 months. The incidence of elevated amylase, AP, HP and moderately elevated amylase after the FCSERMS and PS removed had no statistical differences （3.6% vs. 14. 3%, 0 vs. 2. 9%, 0 vs. 2. 9% , 3.6% vs. 8.6%, all P 〉 0. 05 ）. Conclusion The placement of pancreatic stents in the treatment of BBS with FCSERMS is a simple, safe and effective method for the prevention of post-ERCP pancreatitis.

关 键 词：胰胆管造影术 内窥镜逆行 胰腺炎 全覆膜自膨式可回收金属支架 良性胆管狭窄 

分 类 号：R576[医药卫生—消化系统]