胆管缩切除术会重置胰腺胆管疼痛,这种疼痛不易发生在内,在功能胆管疼痛中注射博托克斯
1Department of Gastroenterology, The Royal Wolverhampton NHS Trust, New Cross Hospital, Wednesfield Road, Wolverhampton, WV10 0QP, UK. shyam.menon@nhs.net.
概括
透视胆道膜切除术 (ES) 可以有效地管理功能胆道疼痛 (FBP) 患者的耐火性胰腺胆道疼痛,在注射肉毒素 (Botox) 后失效. 这种方法提供了持续的症状缓解,并减少了进一步入院的需要.
科学领域:
- 胃肠病学 胃肠病学
- 内分泌学 在内分泌学.
- 疼痛管理 疼痛管理
背景情况:
- 奥迪功能障碍的III型关节,或功能性胆道疼痛 (FBP),带来了管理挑战.
- 间歇性注射肉毒素 (Botox) 进入奥迪的关节可以缓解胰腺胆道疼痛.
- 内镜胆管膜切除术 (ES) 可能为失去对博托克斯治疗反应的患者提供解决方案.
研究的目的:
- 评估内镜胆管缩切除术 (ES) 在功能胆管疼痛 (FBP) 患者的疗效,这些患者对注射肉毒素 (Botox) 失去了反应.
- 评估ES在重置疼痛和促进持续症状管理方面的潜力.
主要方法:
- 对接受间歇性博托克斯注射的130名FBP患者 (2014-2021) 的回顾性审查.
- 患者接受了包括成像 (MRCP/CT,EUS) 在内的诊断工作,以排除其他疼痛原因.
- 失去对博托克斯反应的患者随后接受了ES,并对症状反应进行了跟踪.
主要成果:
- 90%的患者最初对博托克斯注射有反应,81%的患者停止服用阿片类药物.
- 39%的患者在平均6次 (平均8个月) 治疗后对博托克斯失去反应.
- 接受ES治疗的82%的患者报告了胰腺胆道疼痛的临床改善,持续缓解长达8个月.
结论:
- 透视胆管缩切除术 (ES) 可以有效地重置FBP患者的胰腺胆管疼痛,当博托克斯治疗变得无效时.
- ES提供持续的症状缓解,并可能减少严重疼痛的住院治疗.
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