目的:评估内镜逆行胰胆管造影术(ERCP)治疗症状性胰腺分裂(PD)的有效性和安全性,并讨论年轻患者的ERCP程序和结果是否与成人不同。
方法:将有症状的PD患者纳入研究,分为未成年组(年龄≤17岁)和成年组(年龄≥18岁)。对每位患者的临床资料进行回顾,然后通过电话联系患者或审查他们的医疗记录以确定他们的长期随访结局.
结果:82例患者(17例未成年患者和65例成年患者)共进行了141例手术。ERCP指征包括腹痛(39.02%),胰腺炎(12.20%),复发性胰腺炎(36.59%),和其他不适(12.20%)。内镜干预措施包括44.68%的患者内镜下胰腺括约肌切开术,鲜花占26.95%,胰腺导管结石拔除率为19.15%,内镜下鼻胰管引流21.99%,内镜下逆行胰管引流占56.74%。经过41个月的中位随访,总有效率为62.32%.在未成年群体和成年群体之间,在ERCP程序中未观察到显著差异,并发症和长期随访结果。
结论:ERCP是治疗有症状PD的一种安全有效的方法。根据细节,并发症,和后续结果,ERCP程序在未成年组和成年组之间没有差异.
OBJECTIVE: To evaluate the efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP) for the treatment of symptomatic pancreas divisum (PD) and to discuss whether ERCP procedures and outcomes in younger patients differ from those of adults.
METHODS: Symptomatic patients with PD were included in the study and divided into underaged (age ≤17 years) and adult (age ≥18 years) group. The clinical information of each patient was reviewed, and then the patients were contacted by telephone or their medical records were reviewed to determine their long-term followup outcomes.
RESULTS: A total of 141 procedures were performed in 82 patients (17 underaged and 65 adult patients). The ERCP indications included abdominal pain (39.02%), pancreatitis (12.20%), recurrent pancreatitis (36.59%), and other discomfort (12.20%). The endoscopic interventions included endoscopic pancreatic sphincterotomy in 44.68% of the patients, bouginage in 26.95%, pancreatic ductal stone extraction in 19.15%, endoscopic nasopancreatic drainage in 21.99%, and endoscopic retrograde pancreatic drainage in 56.74%. After a median follow-up of 41 months, the overall response rate was 62.32%. Between the underaged group and the adult group, significant differences were not observed in the ERCP procedures, complications and longterm follow-up results.
CONCLUSIONS: ERCP is a safe and effective treatment for symptomatic PD. Based on the details, complications, and follow-up results, the ERCP procedure did not present differences between the underaged and adult groups.