小儿胰腺分裂症内镜治疗分析及文献回顾  

Analysis of endoscopic treatment of pancreatic divisum in children with a literature review

作　　者：粟杰 段栩飞[1] 闫学强[1] 秦鑫锞[1] 朱真闯[1] 梁翀[1] 纪思淇 Su Jie;Duan Xufei;Yan Xueqiang;Qin Xinke;Zhu Zhenchuang;Liang Chong;Ji Siqi(Department of Pediatric Surgery,Wuhan Children's Hospital(Wuhan Maternal&Children's Healthcare Hospital),Tongji Medical College,Huazhong University of Science&Technology,Wuhan 430016,China)

机构地区：[1]华中科技大学同济医学院附属武汉儿童医院普外科,武汉430016

出　　处：《中华小儿外科杂志》2024年第11期998-1003,共6页Chinese Journal of Pediatric Surgery

基　　金：儿童肝胆胰疾病研究室(2022FEYJS004)。

摘　　要：目的探讨内镜下逆行胰胆管造影术(endoscopic retrograde cholangiopancreatogy,ERCP)治疗儿童胰腺分裂症的安全性及疗效。方法收集2020年9月至2022年2月华中科技大学同济医学院附属武汉儿童医院收治的3例胰腺分裂症女患儿的临床资料,平均年龄为8岁10个月,年龄范围是4岁5个月~14岁5个月;其中1例为不完全性,2例为完全性。监测术后血尿淀粉酶等指标,观察有无出血、穿孔、术后胰腺炎等并发症发生,分析随访结果并结合文献对其诊断及治疗进行讨论。结果所有患儿均以反复发作的腹痛为主要症状,进行ERCP操作共5次,行胰管扩张5次,支架置入3次,括约肌切开1次,所有操作均成功。术后淀粉酶恢复正常的平均时间为3.6(1~5)d,一例因胰性腹痛再入院3次,并发症为术后胰腺炎。平均随访时间为9.7(5~12)个月,所有患儿的体格发育水平与术前相比没有差异。结论ERCP治疗儿童胰腺分裂症安全有效,支架植入术是最常用的手术方式,可优先选择球囊或导管扩张,应慎行括约肌切开术。Objective:To explore the safety and efficacy of endoscopic retrograde cholangiopancreatogy(ERCP)for pancreatic divisum(PD)in children.Methods:From September 2020 to February 2022,the relevant clinical data were reviewed retrospectively for 3 PD girls hospitalized at Wuhan Children's Hospital since 2020.their diagnoses and treatments were discussed in conjunctions with the literature.Results:Average age was 106(53-173)months.Recurrent abdominal pain dominated.The clinical types were incomplete(n=1)and complete(n=2).ERCP was performed for 5 times,pancreatic duct dilatation for 5 times,stent implantation thrice and sphincterotomy once.All operations were successful.Average postoperative recovery time of amylase was 3.6(1-5)days.One child was readmitted thrice for pancreatic abdominal pain.The incidence rate of complications was 20%(1/5).The complication was post-ERCP pancreatitis.The average follow-up period was 9.7(5-12)months.Physical development differed insignificantly different from that pre-operation.Conclusion:ERCP is both safe and effective for PD in children.And stenting is the most commonly applied surgery.Balloon or catheter dilatation is preferred.Meticulous sphincterotomy may lower the incidence of complications.Surgery should be prudent for individuals with refractory PD.

关 键 词：胰胆管造影术 内窥镜逆行 胰腺分裂 内镜治疗 儿童 

分 类 号：R726.5[医药卫生—儿科]