Application of endoscopic retrograde cholangiopancreatography in pancreatic duct injury
10.3877/cma.j.issn.2095-3232.2016.06.008
- VernacularTitle:ERCP在胰管损伤中的应用
- Author:
Jiawei MEI
1
;
Mingning ZHAO
;
Wenjie ZHANG
;
Jun GU
;
Wenguang WU
;
Yingbin LIU
;
Xuefeng WANG
Author Information
1. 200092,上海交通大学医学院附属新华医院普通外科
- Keywords:
Pancreatic ducts;
Wounds and injuries;
Pancreatic fistula;
Cholangiopancreatography,endoscopic retrograde
- From:
Chinese Journal of Hepatic Surgery（Electronic Edition）
2016;5(6):376-379
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the application of endoscopic retrograde cholangiopancreatography (ERCP) in pancreatic duct injury. Methods Fourteen patients with pancreatic duct injury who were diagnosed and treated with ERCP in Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine between August 2006 and February 2014 were retrospectively analyzed. Among them, 9 were males and 6 were females, aged 6-77 years old with a median age of 58 years old. Six patients were diagnosed with closed pancreatic injury. Eight cases were complicated with pancreatic fistula after surgery, 3 of whom underwent distal pancreatectomy and 5 underwent distal pancreatectomy combined with splenectomy. The informed consents of all patients were obtained and the local ethical committee approval was received. Patients diagnosed with closed pancreatic injury underwent ERCP. According to the imaging result and American Association for the Surgery of Trauma (AAST) classification, therapeutic measures such as endoscopic retrograde pancreatic drainage (ERPD), and endoscopic retrograde biliary drainage (ERBD) + ERPD were performed. Patients with pancreatic fistula after surgery received ERCP for diagnosis and drainage therapy. The recovery status and incidence of ERCP-related complications after ERCP diagnosis and treatment were observed. Results Six cases were confirmed with closed pancreatic injury by ERCP. According to the AAST classification, 4 cases with grade Ⅲ injury underwent ERPD, and 2 with grade IV injury underwent ERBD + ERPD. Eight cases with pancreatic fistula after surgery were all found with pancreatic duct injury by ERCP and then underwent ERPD. The median healing time of pancreatic fistula after surgery was 16(12-25)d. No severe complication was observed during the treatment of ERCP. All patients were recovered and discharged after ERCP treatment. Biliary and pancreatic duct stents were removed 3 months after discharge. Conclusions ERCP has the advantages of safty and minimally invasion for the diagnosis and treatment of pancreatic duct injury.
