Xie Huawei,Wang Jiheng,Wang Zheng,et al.Two cases of recurrent pancreatitis in children with annular pancreas after operation and literature review[J].Journal of Clinical Pediatric Surgery,2021,20(07):619-623.[doi:10.12260/lcxewkzz.2021.07.004]
儿童环状胰腺手术后复发性胰腺炎二例并文献复习
- Title:
- Two cases of recurrent pancreatitis in children with annular pancreas after operation and literature review
- Keywords:
- Pancreas/AB; Pancreatic Diseases/SU; Pancreatitis/CO
- 分类号:
- R657.51;R725.76;R726.575
- 摘要:
- 目的 探讨儿童环状胰腺手术后复发性胰腺炎的治疗策略。方法 回顾性分析中国人民解放军总医院第七医学中心附属八一儿童医院收治的2例行环状胰腺十二指肠菱形吻合术后3年余，出现复发性胰腺炎患者的临床资料，并对相关文献进行分析。结果 2例经保守治疗7 d后胰腺炎症状消失，于气管插管全身麻醉下行内镜诊治，实施经内镜胰胆管造影术（endoscopic cholangiopancreatography，ERCP），后置入胰管支架，术后1年、3年均未见胰腺炎复发，未更换或取出胰管支架管。对2篇儿童环状胰腺手术后复发性胰腺炎的英文文献进行分析，共纳入7例患者，年龄21个月至10岁；采用ERCP治疗成功4例，失败1例；最终常规手术治疗6例，放弃治疗1例；随访11~54个月，均未见胰腺炎复发。结论 儿童环状胰腺十二指肠旁路手术后出现复发性胰腺炎需明确是否伴发胰胆管畸形，依据随访结果采取不同的治疗策略。
- Abstract:
- Objective Combining the literature to investigate the treatment strategy of recurrent pancreatitis in children with annular pancreas after operation.Methods The clinical and follow-up data of 2 patients with recurrent pancreatitis after duodenoduodenostomy were retrospectively analyzed,and the relevant literature was reviewed and analyzed.Results After conservative treatment for one week,the symptoms of pancreatitis disappeared in 2 children,and endoscopic diagnosis and treatment were performed under general anesthesia.Endoscopic cholangiopancreatography (ERCP) were performed,followed by placement of pancreatic duct stents.No episodes of pancreatitis were observed and no pancreatic duct stents were replaced or removed during the postoperative follow-up period of 1year and 3years.At the same time,an English literature including 7 children aged from 21 months to 10 years was analyzed.Four cases were successfully treated with ERCP and 1 case failed.In the end,conventional surgical treatments were performed in 5 cases and abandoned in 1 case.The follow-up period was 11-54 months,and no recurrence of pancreatitis was observed.Conclusion If recurrent pancreatitis occurs after duodenal bypass surgery in children,it is necessary to determine whether annular pancreas is accompanied by cholangiopancreatosis,and different treatment strategies should be adopted according to the results.
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相似文献/References:
[1]陈功.小儿胰腺外科相关疾病的诊治回顾与展望[J].临床小儿外科杂志,2021,20(07):601.[doi:10.12260/lcxewkzz.2021.07.001]
Chen Gong.Progress in diagnosis and treatment of pediatric pancreatic surgery related diseases[J].Journal of Clinical Pediatric Surgery,2021,20(07):601.[doi:10.12260/lcxewkzz.2021.07.001]
备注/Memo
收稿日期:2020-12-01。
基金项目:军队创新重点项目（编号：16JS001）
通讯作者:黄柳明,Email:surhlm@126.com