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The Clinical Value of and Curative Effect of Therapeutic ERCP in Serious Pancreatic Diseases

Author: ChiYuanWei
Tutor: ChenJian
School: Shandong University
Course: Digestion within the science
Keywords: ERCP Severe Acute Pancreatitis Pancreatic Cancer The clinical value Biliary calculi Therapeutic Vater Stenting Complication Pancreatic disease Biliary tract infection Impacted stones Lithotomy Common bile duct Cholangitis biliary Severe pancreatitis Endoscopy Efficacy Residual stones
CLC: R657.51
Type: Master's thesis
Year: 2011
Downloads: 28
Quote: 0
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Abstract


Background Acute pancreatitis biliary (acute pancreatitis biliary ABP), and pancreatic cancer are the most common critical of pancreatic diseases. ABP accounted for the total number of about 30%-45% of acute pancreatitis every year. The death rate of ABP are as nearly as20-35%All countries whether developed or developing countries, calculous biliary diseases are the main factors to trigger.When biliary calculi removes, embedded in a pot belly cause obstruction, or in a pot belly through, can cause temporary obstruction and cause the duodenum nipple edema or is of Oddi sphincter contracture, and thus cause bile reflux pipe into the pancreas, or is in the pancreas local form pancreatic duct, high pressure trigger pancreatitis occurs. In recent years,with the development of Endoscopic retrograde cholangiopancreatography (ERCP), stone-free remove gallstone obstruction with ERCP, has become one of the important treatment and effective method in ABP, made satisfactory treatment effect, and greatly reduce the complications of pancreatitis incidence and mortality. At the same time, endoscopic treatment method is simple ,tolerability is good, and the complication rate is low, it can be said that at present ERCP has been widely accepted as the preferred methods of treatment in ABP.At present the incidence of pancreatic cancer at home and abroad has increased year by year, at the same time the early symptoms are not obviously, when finding jaundice, abdominal discomfort,it is often very late, so that pancreatic cancer has a name of "king of the cancer". At present the radical surgery surgical pancreatic cancer, especially Whipple surgery,has the high risk, and the surgery complications and death rates are higher. Endoscopic metal biliary endoprothesis (EMBD) has small trauma, quick recovery, less pain patients, easy to accept, less postoperative complications etc, and can effectively improve the patients with pancreatic cancer survival rates, improve the quality of life, reduce pain patients, has become a reliable and effective in patients with pancreatic cancer conservative treatment method. In this study we will relate and analyze the clinical treatment effects of 18 cases of ABP and 20 cases of pancreatic cancer,the cases which were collected from our department from 2008.12-2010.8.Objective:Retrospectively analysis was made to evaluate The clinicial value and curative effect of therapeutic ERCP in 38 cases of severe pancreatic diseases.Methods:18 cases of acute biliary pancreatitis and 20 cases of pancreatic cancer were executed with ERCP, in order to evaluate achievement ratio of operation and ratio of postoperative complications.Results:16 cases of acute biliary pancreatitis were calculus removed, achievement ratio of operation is 88.9%,only one patient had biliary department infection,the ratio of postoperative complications is 6.2%.20 cases of pancreatic cancer were successfully executed with EMBD, achievement ratio of operation is 100%, and the postoperative effective power is 90%,2 patients had biliary department infection,,the ratio of postoperative complications is 15%, the serum level of total bilirubin decreased from 226.28±108.90μmol/L to 96.38±70.23μmol/L (P<0.01), the ratio of stent blockage is 10% and 30% after 3 months and 6months of operation.The survival rate after 3 months,6months and 12months is 66.7%.27.8%和11.1%.Conclusion:ERCP play an irreplaceable role in the treatment of acute biliary pancreatitis and pancreatic cancer.

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CLC: > Medicine, health > Surgery > Of surgery > Abdominal surgery > Pancreas > Pancreatitis
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