内镜逆行胰胆管造影治疗胰管结石的要点评价OA

Pancreatic duct stone is a characteristic pathological manifestation of chronic pancreatitis.Stone can cause obstruction of pancreatic juice excretion,leading to high pressure of pancreatic duct and pancreatic parenchyma,damaging the structure and endocrine function of pancreatic glands,accelerating the progression of chronic pancreatitis,and forming the vicious cycle of chronic pancreatitis stones with pancreatic high pressure.Surgical treatment is the main method for treating pancreatic duct stone in China,but it has many disadvantages such as high trauma and high incidence of early complications.Endoscopic retrograde cholangiopancreatography(ERCP)can reduce pancreatic duct pressure and meet the basic requirements of relieving clinical symptoms.ERCP can also remove stones,relieve stenosis,and facilitate pancreatic juice drainage.It gradually becomes the preferred method for the treatment of pancreatic duct stone for the advantages of minimal trauma,high safety,and strong repeatability.ERCP also has various complications such as bleeding,perforation,failed stone retrieval,and stent displacement.It is important to master the operating techniques and indications of instruments such as dilation balloons,stone baskets,stone retrieval baskets,and pancreatic duct stents.In this article we will summarize our experience of more than 20 years in treating pancreatic duct stones,and discuss the indications,complications,and operational techniques of ERCP treatment for pancreatic duct stones based on domestic and foreign relevant literature.It proposes that ERCP can be chosen directly to remove pancreatic duct stone with a diameter less than or equal 5 mm,fragmentation techniques can be used for stone with a diameter greater than 5mm,and fully covered metal stent can be used to treat pancreatic duct structure,providing reference for standardized ERCP treatment of pancreatic duct stone.