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首页> 美国卫生研究院文献>Endoscopy International Open >Pancreatic sphincterotomy improves pain symptoms due to branch-duct intrapapillary mucinous neoplasia without worrisome features: a multicenter study
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Pancreatic sphincterotomy improves pain symptoms due to branch-duct intrapapillary mucinous neoplasia without worrisome features: a multicenter study

机译：一项多中心研究表明胰腺括约肌切开术可改善分支性导管内乳头状粘液瘤形成所致的疼痛症状

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>Introduction  Branch duct intraductal papillary mucinous neoplasms (BD-IPMNs) require follow-up to detect worrisome features (WF). Data are missing about endoscopic pancreatic sphincterotomy (PS) for symptomatic IPMN. >Patients and methods  This was a retrospective multicenter study in four expert centers. Patients treated with endoscopic PS for symptomatic (painful) BD-IPMN without WF were included. Age, sex, follow-up time, characteristics of IPMNs and endoscopic retrograde cholangiopancreatographies (ERCPs), and indications for surgery were recorded. >Results  In total, 21 patients were included (median age 68 years, range 45 – 87 years). The median number of cysts was 2 (range 1 – 10), located in the head (59 %), body/tail (17 %), or multifocal (24 %). ERCP including PS was completed in all of the cases, with biliary sphincterotomy in 33 %. Clinical efficacy after one session was 81 % (17/21). Among the failures, one had a second successful PS and three were operated. The final efficacy was 86 % (18/21). Seven patients were operated after a mean of 19 months: four for WF, three for pain. The histopathology showed four low grade dysplasia, one high grade dysplasia, and two no dysplasia. No adenocarcinoma occurred during a follow-up of 99 months (range 14 – 276 months). >Conclusions  Endoscopic PS for symptomatic IPMN without WF is effective in more than 80 % of cases, without increasing the risk for adenocarcinoma.
机译：>简介 require分支导管导管内乳头状黏液性肿瘤（BD-IPMNs）需要进行随访以检测令人担忧的特征（WF）。关于有症状IPMN的内镜胰括约肌切开术（PS）的数据缺失。 >患者和方法这是在四个专家中心进行的一项回顾性多中心研究。纳入接受内镜PS治疗的症状性（疼痛性）BD-IPMN而无WF的患者。记录年龄，性别，随访时间，IPMNs的特征和内镜逆行胰胆管造影（ERCP），以及手术指征。 >结果总共纳入21例患者（中位年龄68岁，范围45-87岁）。囊肿的中位数为2个（范围1 -10），位于头部（59％），体/尾（17％）或多焦点（24％）。所有病例均完成包括PS在内的ERCP，胆囊括约肌切开术占33％。一疗程后的临床疗效为81％（17/21）。在这些故障中，有一个获得了第二次成功的PS，三个已运行。最终疗效为86％（18/21）。平均19个月后有7例患者接受了手术：4例为WF，3例为疼痛。组织病理学显示有四个低度不典型增生，一个高度不典型增生，和两个没有非典型增生。在99个月的随访中（14 –276个月）未发生腺癌。 >结论 without内镜下无症状的IPMN的内镜PS治疗80％以上的病例有效，而不会增加患上腺癌的风险。

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