经内镜逆行胰胆管造影术治疗成年胰腺分裂伴慢性胰腺炎的长期随访研究  

Long-term outcomes of endoscopic retrograde cholangiopancreatography for pancreas divisum with chronic pancreatitis in adults

作　　者：崔光星 吕文[1] 杨建锋 黄海涛 金杭斌 楼奇峰 王晖 张筱凤 Cui Guangxing;Lyu Wen;Yang Jianfeng;Huang Haitao;Jin Hangbin;Lou Qifeng;Wang Hui;Zhang Xiaofeng(Department of Qistroenterology,Affiliated Hangzhou First People's Hospital,Zhejiang University School of Medicine,Hangzhou 310006,China)

机构地区：[1]浙江大学医学院附属杭州市第一人民医院消化内科,310006

出　　处：《中华消化内镜杂志》2021年第11期866-870,共5页Chinese Journal of Digestive Endoscopy

基　　金：浙江省医药卫生科技计划项目(2021KY882)。

摘　　要：目的评价经内镜逆行性胰胆管造影术(endoscopic retrograde cholangiopancreatography,ERCP)治疗成人胰腺分裂(pancreas divisum,PD)伴慢性胰腺炎(chronic pancreatitis,CP)的安全性和有效性。方法回顾性分析2008年1月-2020年1月在浙江大学医学院附属杭州市第一人民医院行ERCP诊治的18周岁以上PD伴CP患者的资料,详细记录患者的一般资料、ERCP下诊治情况、随访资料等,并对比术前和术后胰腺炎发作次数、腹痛视觉模拟评分(visual analogue scale,VAS)和主胰管直径等指标。结果共61例PD伴CP患者纳入研究,实施ERCP总计301例次,ERCP中位例次为4次(3.0~6.5次),放置胰管支架的中位例次为3次(2~6次)。首次ERCP副乳头插管成功率为90.2%(55/61),总的副乳头插管成功率为98.0%(295/301);首次ERCP有效率为82.0%(50/61),总的ERCP并发症发生率为2.7%(8/301)。中位随访54个月(31.0~97.5个月)。与术前比较,术后每年胰腺炎的中位发作次数由2.40次减少至0次(Z=-6.726,P<0.001)、术后中位VAS由7分降低至2分(Z=-6.621,P<0.001)、术后中位主胰管直径由5.0 mm缩小至4.0 mm(Z=-2.330,P=0.020),而体重由术前的(56.04±10.75)kg增加至术后1年的(58.62±10.79)kg(t=-5.285,P<0.001)。结论ERCP诊治成人PD伴CP安全有效。Objective To evaluate the safety and effieacy of endoscopie retrograde cholangiopancreatography(ERCP)for pancreas divisum(PD)with chronic pancreatitis(CP)in adults.Methods Data of patients older than 18 years old diagnosed as having PD with CP in Hangzhou First People's Hospital from Janwary 2008 to January 2020 were retrospectively analyzed,i.e.the general information,ERCP procedures and fllow-up data of the patients.The number of acute pancreatitis attacks,visual analogue scale(VAS)of abdominal pain,and the diameter of pancreatic duct before and after ERCP were compared.Results A total of 61 patients diagnosed as having PD with CP undenwent 301 ERCP procedures with the median number of 4(3.0-6.5).'The median number of pancreatic stent replacement was 3(2-6).The success rate of the first minor papilla cannulaion was 90.2%(55/61),and the total success rate of minor papilla cannulation was 98.0%(295/301).The efficacy rate of the first ERCP was 82.0%(50/61).ERCP-related complication rate was 2.7%6(8/301).The median ollow-up time was 54 months(31.0-97.5 months).The median number of acute pancreatitis attacks deereased from 2.40 to 0(Z=-6.726,P<0.001)compared with that before ERCP.The median VAS deereased from 7 to 2(Z=-6.621,P<0.001).The median pancreatie duct diameter deereased from 5.0 mm to 4.0 mm(Z=-2.330,P=0.020).However,the mean weight increased from 56.04+10.75 kg to 58.62+10.79 kg(1=-5.285,P<0.001)one year after the procedure.Conclusion ERCP is safe and effective in the diagnosis and treatment of PD with CP in adults.

关 键 词：胰胆管造影术 内窥镜逆行 胰腺炎 慢性 胰腺分裂 成人 内镜治疗 

分 类 号：R657.5[医药卫生—外科学]