重型慢性胰腺炎支架植入后长期结果

作     者：Eleftheriadis N Dinu F Delhaye M. J.Devière 王志宇 

作者机构：Department of Gast roenterology UniversitéLibre De Bruxelles Hpital Erasme Route de Lennik 80 8 1070 Brussels Belgium.Dr 

出 版 物：《世界核心医学期刊文摘（胃肠病学分册）》 (Core Journals in Gastroenterology)

年 卷 期：2005年第1卷第8期

页      面：16-17页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：慢性胰腺炎 支架植入 胰空肠吻合术 良好反应 疼痛控制 内镜检查 回顾性评价 

摘      要：Background and Study Aims: Although it has been proved that pancreatic stentin g is effective in the symptomatic management of severe chronic pancreatitis, lon g-term outcomes after stent removal have not been fully evaluated. Patients and Methods: A total of 100 patients (75 men, 25 women; median age 49) with severe chronic pancreatitis and pancreatic duct strictures were successfully treated fo r pancreatic pain using polyethylene pancreatic stents and were followed up for at least 1 year after stent removal. The stents were exchanged “on demand (in cases of recurrence of pain) and a definitive stent removal was attempted on the basis of clinical and endoscopic findings. Clinical variables were retrospectiv ely assessed as potential predictors of re-stenting. Results: The etiology of t he chronic pancreatitis was alcoholic (77%), idiopathic (18%), or hereditary ( 5%). Patients were followed up for a median period of 69 months (range 14-163 months) after study entry, including a median period of 27 months (range 12 -12 6 months) after stent removal. The median duration of pancreatic stenting before stent removal was 23 months (range 2 -134 months). After attempted definitive stent removal, 30 patients (30%) required re-stenting within the first year of follow-up, at a median time of 5.5 months after stent removal (range 1-12 mon ths), while in 70 patients (70%) pain control remained adequate during that period. By the end of the follow-up period a total of 38 patients had require d re-stenting and four ultimately underwent pancreaticojejunostomy. Pancreas di visum was the only factor significantly associated with a higher risk of re-ste nting (P = 0.002). Conclusions: The majority (70%) of patients with severe chro nic pancreatitis who respond to pancreatic stenting maintain this response after definitive stent removal. However,a significantly higher re-stenting rate was observed in patients with chronic pancreatitis and pancreas divisum.