中国实用外科杂志

中国实用外科杂志 ›› 2011, Vol. 31 ›› Issue (09): 788-791.

• 专题笔谈 • 上一篇    下一篇

慢性胰腺炎的外科治疗及术式评价

杨尹默，马永蔌，高红桥，庄    岩   

  1. 北京大学第一医院普通外科，北京100034
  • 出版日期:2011-09-01 发布日期:2011-08-19

  • Online:2011-09-01 Published:2011-08-19

PDF

摘要：

慢性胰腺炎的典型临床特征为持续性不可逆的炎症过程、反复发作的疼痛症状和进行性丧失的胰腺内分泌与外分泌功能。其病理学改变包括胰腺实质的纤维化、胰腺导管的解剖性狭窄与扩张、可并发胰腺实质的钙化或胰管结石等。酗酒是慢性胰腺炎最常见的病因。评价慢性胰腺炎外科治疗效果的标准是临床症状的缓解程度，术式包括引流手术（Peustow手术，Partington and Rochelle手术等）、不同范围的胰腺切除手术以及上述两种术式的联合（Beger手术，Frey手术等）。由于慢性胰腺炎的临床症状、病理学改变及影像学表现的复杂性，治疗上不可一概而论，更不可随意而为，在选择内科、内镜或外科特别是外科何种术式做为病人治疗的途径时，应对上述方式有非常清楚的理解，个体化应用，使病人最大获益。

关键词: 慢性胰腺炎, 外科治疗, 内镜治疗, 个体化

Abstract:

The surgical managements for chronic pancreatitis and the evaluation of the procedures        YANG Yin-mo, MA Yong-su, GAO Hong-qiao, et al. Department of General Surgery, Peking University The First Hospital, Beijing100034， China
Corresponding author: E-mail：yangyinmo@263.net
Abstract    Chronic pancreatitis is usually characterised by a persistent inflammtory process, recurrent painful attacks and progressive loss of pancreatic endocrine and exocrine function. Its pathological change encludes fibrosis of the parenchyma, anatomic stricture and dilatation of the pancreatic duct, with or without calcification or stone. It is most commonly caused by the abuse of alcohol. The evaluation criterion for a successful treatment is the degree of symptomatic relief. The surgical management aimed at the pancrease includes simple drainage procedures（Peustow procedure, Partington and Rochelle procedure, et al）, resections of different extents or a combination of both（Beger procedure, Frey procedure, et al）. For the complexity of the symptomatology, pathology and radiology, the managements would be diversified. Whether surgery, endotherapy or other modalities are applied, individualization according to the surgical indications should be kept in mind.

Key words: chronic pancreatitis, surgical management, endotherapy, individualization