中国实用外科杂志2023，Vol.43Issue(12)：1436-1440,5.DOI:10.19538/j.cjps.issn1005-2208.2023.12.23
胰管断裂综合征诊治现状
Diagnosis and treatment status of disconnected pancreat-ic duct syndrome
摘要
Abstract
Disconnected Pancreatic Duct Syndrome,(DPDS)is a significant complication of acute necrotizing pancreatitis(ANP).It results from the rupture of the pancreatic duct,caus-ing abnormal pancreatic fluid drainage into the gastrointestinal tract.DPDS often leads to recurrent enveloping pancreatic ne-crosis,pancreatic pseudocysts,and chronic pancreatitis.The primary trigger is the main pancreatic duct necrosis,predomi-nantly occurring in the pancreatic neck.Diagnostic methods commonly employed include non-invasive and invasive proce-dures.Non-invasive methods encompass computed tomography(CT)or contrast-enhanced CT(CECT),magnetic resonance cholangiopancreatography(MRCP),and secretin-enhanced magnetic resonance cholangiopancreatography(S-MRCP),as-sessing pancreatic duct integrity and rupture site.Invasive pro-cedures include endoscopic retrograde cholangiopancreatogra-phy(ERCP),endoscopic ultrasound(EUS),and surgical explora-tion,with ERCP currently being the gold standard,revealing the extravasation of contrast agents.MRCP or S-MRCP is rec-ommended as the preferred diagnostic approach.The objective of DPDS treatment is adequate drainage of accumulated pan-creatic fluid.Treatment modalities comprise conservative man-agement,percutaneous drainage,and endoscopic,or surgical interventions.Conservative and percutaneous drainage have limited efficacy and do not reconstruct the ruptured pancreatic duct.Endoscopic interventions involve transmural drainage and physiological drainage via the papilla,utilizing various stents such as LAMS,plastic stents,etc.Surgical interventions encompass distal pancreatic resection and internal drainage,suitable for patients experiencing difficulties with endoscopic treatment or recurrent episodes.关键词
急性坏死性胰腺炎/胰管断裂综合征/主胰管断裂/包裹性坏死/慢性胰腺炎Key words
acute necrotizing pancreatitis/disconnected pan-creatic duct syndrome/main pancreatic duct/walled-off necro-sis/chronic pancreatitis分类
医药卫生引用本文复制引用
苏铁,武林枫,王刚..胰管断裂综合征诊治现状[J].中国实用外科杂志,2023,43(12):1436-1440,5.基金项目
国家自然科学基金项目(No.82070657,No.82370651) （No.82070657,No.82370651）
