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首页> 外文期刊>European journal of gastroenterology and hepatology >Endoscopic pancreatic duct stenting for relief of pancreatic cancer pain.
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Endoscopic pancreatic duct stenting for relief of pancreatic cancer pain.

机译：内镜胰管支架置入术可减轻胰腺癌疼痛。

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INTRODUCTION: Little is known about the effects of endoscopic pancreatic duct (PD) decompression in patients with 'obstructive type' pain from pancreatic carcinoma. METHODS: Twenty patients with unresectable carcinoma of the pancreas, PD obstruction and postprandial epigastric pain were enrolled. The pain intensity, opioid dose and quality-of-life index were documented pre-treatment and at 4-weekly intervals. PD stenting was attempted in all patients. PD stent change was performed if biliary stents had to be changed or intense pain relapsed. RESULTS: Endoscopic PD drainage was successful in 19/20 patients by placement of a 7 F (n = 9) or 10 F (n = 10) plastic stent. Median follow-up was 16 weeks. Two patients were alive at the end of follow-up. Eleven patients received gemcitabine chemotherapy. The pre-interventional pain score was 6.7 +/- 0.9 points and decreased to 3.1 +/-1.4 points at 4 weeks (P < 0.001). It remained lowered significantly at 8/12 weeks and at the final visit (4.2 +/- 1.5 points, n = 13). The mean pre-stenting fentanyl dose was 85.5 +/- 34.7 microg/h, and it was decreased to 57.9 +/- 39.1 microg/h after 4 weeks (P < 0.01), 60.5 +/- 38.9 microg/h after 8 weeks and 64.1+/-39.8 microg/h (P < 0.01 versus pre-treatment) after 12 weeks but increased to 82.7 +/- 41.3 microg/h (NS) at the final visit. The quality-of-life index improved 4 weeks after stenting (from 4.8+/-1 to 6.2+/-1.5 points, P < 0.01) but was lowered to 5.5 +/- 2.3 points at 12 weeks (NS). The response was independent of stent diameter and chemotherapy. CONCLUSION: PD stenting achieved significant pain relief and short-term improvement of the quality of life in the majority of patients with PD obstruction due to pancreatic carcinoma.
机译：简介：内镜胰管减压术对胰腺癌“阻塞型”疼痛的影响知之甚少。方法：招募了20例不可切除的胰腺癌，PD阻塞和餐后上腹痛的患者。治疗前和每隔4周记录疼痛强度，阿片类药物剂量和生活质量指数。在所有患者中均尝试了PD支架置入术。如果必须更换胆道支架或复发剧烈疼痛，则进行PD支架更换。结果：通过放置7 F（n = 9）或10 F（n = 10）的塑料支架，在19/20例患者中成功通过内窥镜PD引流。中位随访时间为16周。随访结束时有两名患者还活着。 11例患者接受了吉西他滨化疗。干预前的疼痛评分为6.7 +/- 0.9分，而在4周时降至3.1 +/- 1.4分（P <0.001）。在第8/12周和最后一次访视时，它仍显着降低（4.2 +/- 1.5分，n = 13）。芬太尼置入支架前的平均剂量为85.5 +/- 34.7 microg / h，4周后降至57.9 +/- 39.1 microg / h（P <0.01），8周后降至60.5 +/- 38.9 microg / h 12周后为64.1 +/- 39.8 microg / h（与预处理相比，P <0.01），但在最终访视时增加至82.7 +/- 41.3 microg / h（NS）。置入支架后4周的生活质量指数有所改善（从4.8 +/- 1降至6.2 +/- 1.5点，P <0.01），但在12周时（NS）降至5.5 +/- 2.3点。反应与支架直径和化疗无关。结论：PD支架置入术可显着缓解大多数胰腺癌所致PD梗阻患者的疼痛，并短期改善其生活质量。

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