在胰腺狭窄和结石的内镜干预 - 一个结构化的方法
Manu Tandan1, Partha Pal2, Nitin Jagtap2
1Medical Gastroenterology, Asian Institute of Gastroenterology, Somajiguda, 6-3-661, Hyderabad, 500 082, India. mantan_05@rediffmail.com.
概括
慢性胰腺炎的疼痛,通常是由胰腺管石或狭窄引起的,可以通过内镜逆行胆血管学 (ERCP) 进行管理. ERCP和体外冲击波石术 (ESWL) 是有效的石头去除和狭窄治疗.
科学领域:
- 胃肠病学 胃肠病学
- 内分泌学 在内分泌学.
- 手术技术 手术技术
背景情况:
- 慢性胰腺炎 (CP) 是不可逆转的,导致胰腺组织的破坏和功能损失.
- 疼痛是主要的症状,通常是由于主要胰腺管 (MPD) 受到石头或狭窄的阻塞造成的.
- 由阻塞引起的管道高血压是CP疼痛的常见原因.
研究的目的:
- 概述当前治疗策略,以管理慢性胰腺炎的疼痛.
- 突出内逆行胆血管学 (ERCP) 和体外冲击波石术 (ESWL) 在治疗MPD石头和狭窄症中的作用.
主要方法:
- 内镜逆行胆血管学 (ERCP) 用支架用于MPD狭窄.
- 带有气球拖的ERCP用于小型MPD计算器提取.
- 身体外冲击波石 (ESWL) 用于大胰腺石块的碎片化.
- 作为一种不断发展的技术,单个操作员胰腺镜与导管内透术.
主要成果:
- 建议ERCP和支架作为MPD狭窄的第一线治疗.
- 带有气球拖网的ERCP有效地去除了小型MPD计算.
- ESWL是大型石块,碎石的标准,用于随后的ERCP提取.
- 当ESWL无法使用或无效时,胰腺镜检查提供了一个替代方案.
结论:
- 最少侵入性内镜技术是管理CP疼痛的核心.
- ERCP,ESWL和胰腺扫描为胰腺管道石头和狭窄管理提供了有效的选择.
- 治疗选择取决于石头的大小,狭窄的存在以及可用的技术.
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