摘要
目的比较胰腺假性囊肿与包裹性坏死(walled-off necrosis,WON)的内镜引流效果。方法回顾性分析解放军总医院第一医学中心2007-2017年继发于急性或慢性胰腺炎、胰腺术后的胰腺假性囊肿及WON并行内镜下引流患者的临床资料,比较两组内镜操作成功率、治疗有效率、内镜治疗次数、放置支架数量、住院时间、并发症、复发率、病变消失所需时间。结果共纳入23例患者,其中胰腺假性囊肿13例(男6例,女7例,平均年龄48岁),WON 10例(男8例,女2例,平均年龄39岁)。两组的内镜操作成功率、治疗有效率、内镜治疗次数、联合鼻囊肿引流管置入及内镜下胰腺坏死组织清创术均无统计学差异;但胰腺假性囊肿组放置塑料支架中位数少于WON组(Md[Min,Max]:1[3,0]vs 2[8,0],P=0.031)。两组术后并发症发生率、并发症处理、术后复发率、后续治疗、病变消失所需时间均无统计学差异;但胰腺假性囊肿组术后住院中位时间少于WON组(Md[Min,Max]:12[6.5,22.5]d vs 22.5[13.75,60.5]d,P=0.042)。结论与胰腺假性囊肿相比,WON的内镜治疗更困难,所需塑料支架数量更多,且术后住院时间更长。
Objective To compare the effect of endoscopic transmural drainage for pancreatic pseudocyst versus walled-off necrosis(WON).Methods From 2007 to 2017,patients with pancreatic pseudocyst or WON admitted to our department who received endoscopic transmural drainage were all included.Technical success rate,treatment success rate,times of endoscopic treatment,number of stents placed,length of hospital stay,adverse events,recurrence,and follow-up length for pseudocyst or WON disappeared were recorded and compared.Results Totally 23 patients were included in this study,13 patients(6 males and 7 females with average age of 48 years)diagnosed as pancreatic pseudocyst and 10 patients(8 males and 2 females with average age of 39 years)diagnosed as WON.There was no significant difference in technical success rate,treatment success rate,times of endoscopic treatment,additional nasocystic drainage and endoscopic necrosectomy between the two groups.While the total number of stents needed in pancreatic pseudocyst group was less than that in WON group(Md[Min,Max]:1[0,3]vs 2[0,8],P=0.031).Meanwhile,adverse events,adverse events managements,recurrence,subsequent treatment and follow-up length for lesions disappeared had no statistical difference between the two groups;however,the length of hospital stay in pancreatic pseudocyst group was less than that in WON group(Md[Min,Max]:12[6.5,22.5]d vs 22.5[13.75,60.5]d,P=0.042).Conclusion EUS-guided endoscopic transmural drainage for treatment of WON is associated with more stents and longer hospital stay when compared with pancreatic pseudocyst.
作者
刘方
王子恺
徐丽娟
李明阳
郭旭
张修礼
蔡逢春
李闻
LIU Fang;WANG Zikai;XU Lijuan;LI Mingyang;GUO Xu;ZHANG Xiuli;CAI Fengchun;LI Wen(Department of Gastroenterology and Hepatology,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China)
出处
《解放军医学院学报》
CAS
2019年第12期1142-1147,共6页
Academic Journal of Chinese PLA Medical School
基金
国家自然科学基金资助项目(81370483).
关键词
胰腺假性囊肿
胰腺包裹性坏死
内镜下引流
pancreatic pseudocyst
pancreatic walled-off necrosis
endoscopic transmural drainage
作者简介
刘方,女,博士,主治医师。研究方向:消化内科及内镜学。Email:bigdimple@sina.cn;通信作者:李闻,男,博士,主任医师,科室副主任。Email:liwen 2000@yahoo.com
