摘要
目的探讨与主胰管相通的胰腺假性囊肿使用经内镜逆行胰胆管造影(ERCP)后十二指肠镜下胰管支架置入联合超声内镜(EUS)引导下经胃穿刺支架置入引流的临床疗效。方法 5例经CT、MRI证实与主胰管相通的胰腺假性囊肿患者,十二指肠镜下主胰管支架置入成功后又在EUS引导下经胃穿刺置入双猪尾塑料支架或全覆膜金属支架进行双向引流。观察患者术后并发症、囊肿消失及缩小的时间。结果随访过程中,1例术后发热,囊液培养出革兰阴性杆菌,给予敏感抗生素治疗后症状消失;1例术后血淀粉酶一过性升高;所有病例囊肿均完全消失,消失时间分别为术后14 d、18 d、1月、1.5月、1.5月。囊肿消失1个月后拔岀全覆膜金属支架,3个月后拔除内引流支架,同时拔出胰管支架。5例患者均痊愈,随访1年无1例复发。结论一步法"ERCP-EUS"联合治疗交通性胰腺假性囊肿安全可靠,疗效更佳。
Objective To explore clinical effects of the treatment method of pancreatic duct stenting by en- doscopic retrograde cholangio pancreatography （ERCP） combined with endoscopic ultrasound （EUS）-guided transgastric stenting for pancreatic pseudocyst connected with the main pancreatic duct. Methods 5 cases of pancreatic pseudocyst communicated with the main pancreatic duct were confirmed by CT or MRI. After the successful input of the main pancreatic duct stent through ERCP, endoscopic ultrasound （EUS）-guided trans- gastric double pigtail plastic or full-covered mental stent were adopted for two-way drainage of pancreatic pseudocyst. Then the postoperative complications and the time the cysts disappeared or reduced were ob- served. Result In the process of follow-up, one case had high fever after operation, bacteria culture for cystic fluid revealed one gram-negative bacilli, the symptom completely disappeared after the sensitive antibiotic was given. 1 case had hyper-amylasemia occasionally. All cases of pancreatic pseudocyst were completely dis- appeared, and the time of pancreatic pseudocyst disappear were 14 days, 18 days, 1 months, 1.5 months, and 1.5 months respectively. The mental stent was removed 1 month after cyte disappearance the plastic stent and main pancreatic duct stent were removed 3 months after cyte disappearanc. All the patients were recovered, no case was found recurrence for 1 years fellow-up. Conclusion The treatment method of One-step ＂ERCP- EUS＂ combination is a safe and reliable method for pancreatic pseudocyst communicated with the main pan- creatic duct.
出处
《兰州大学学报（医学版）》
CAS
2015年第1期55-59,共5页
Journal of Lanzhou University（Medical Sciences）
基金
甘肃省科技计划基金项目(1010RJZA119)
关键词
经内镜逆行胰胆管造影
超声内镜
胰腺假性囊肿
endoscopic retrograde cholangio pancreatography
endoscopic ultrasound
pancreatic pseudocyst
