经内镜逆行胰管支架引流术治疗胰瘘的临床价值
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1.河南省人民医院消化科;2.上海长海医院消化科

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基金项目:

河南省卫生健康委员会项目(201503158)


Clinical value of endoscopic retrograde pancreatic drainage for pancreatic fistula
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Affiliation:

Henan provincial people''s Hospital

Fund Project:

Health comission of Henan Province fund(201503158)

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    摘要:

    目的 探讨经内镜逆行胰管支架引流术(ERPD)治疗胰瘘的临床价值。方法 回顾性分析2013年6月至2018年9月在海军军医大学长海医院及河南省人民医院采用ERPD诊治的42例胰瘘患者的临床资料,观察胰瘘治愈率、胰瘘愈合时间及并发症发生率等指标。结果 42例胰瘘患者中男30例(71.4%)、女12例(28.6%),年龄(41.5±12.8)岁。37例(88.1%)患者胰管支架越过瘘口,胰瘘总体治愈率90.5%(38/42),胰瘘中位愈合时间32.0 d(8~183 d)。外伤后胰瘘[(19.0±9.9)d,t=3.50,P=0.002]和外科手术后胰瘘[(20.3±10.7)d,t=3.35,P=0.003]的愈合时间短于急性重症胰腺炎后胰瘘愈合时间[(60.0±48.6)d]。胰腺假性囊肿者与无胰腺假性囊肿者胰瘘愈合时间比较,差异有统计学意义[(65.3±55.4) d比(32.6±23.6) d,t=2.21,P=0.040]。不同部位胰瘘在胰瘘治愈率、胰瘘愈合时间、ERCP次数方面差异无统计学意义(P均>0.05)。2例(4.8%)患者术后出现支架相关并发症,1例(2.4%)出现轻度胰腺炎。结论 ERPD是治疗胰瘘的重要手段,治疗效果好、并发症低。

    Abstract:

    Objective To evaluate the clinical value of endoscopic retrograde pancreatic drainage (ERPD) in patients with pancreatic fistula. Methods Data of 42 patients with pancreatic fistula, who were treated with ERPD at Changhai Hospital and Henan Provincial People′s Hospital from June 2013 to September 2018,were collected. The pancreatic fistula curative rate,healing duration of pancreatic fistula, and the incidence of complications were analyzed. Results Among 42 patients with pancreatic fistula,there were 30 males(71.4%) and 12 females(28.6%) with mean age of 41.5±12.8 years old. Pancreatic duct stents of 37 cases (88.1%) went across the fistula. The overall curative rate was 90.5%(38/42). The median healing duration of pancreatic fistula was 32.0 d (8-183 d). The healing time of pancreatic fistula after injury(19.0±9.9 d,t=3.50,P=0.002) and of pancreatic fistula after surgery(20.3±10.7 d,t=3.35,P=0.003) were shorter than that of pancreatic fistula after acute severe pancreatitis (60.0±48.6 d). The healing time of pancreatic fistula with pancreatic pseudocysts was longer than that of pancreatic fistula without pancreatic pseudocysts (65.3±55.4 d VS 32.6±23.6 d, t=2.21,P=0.040). There were no significant differences in pancreatic fistula curative rate, pancreatic healing duration and times of ERCP in pancreatic fistula at different position.Postoperative stent-related complications occurred in 2 patients (4.8%), and 1 patient (2.4%) developed mild pancreatitis. Conclusion ERPD is an important treating method with good therapeutic effect and low complications for pancreatic fistula.

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刘博伟,王伟,施新岗,等.经内镜逆行胰管支架引流术治疗胰瘘的临床价值[J].中华消化内镜杂志,2019,36(6):407-410.

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  • 收稿日期:2019-02-20
  • 最后修改日期:2019-05-10
  • 录用日期:2019-03-25
  • 在线发布日期: 2019-06-21
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