| 特集名 | 消化器疾患に対するステント治療 | |
|---|---|---|
| 題名 | 慢性膵炎の主膵管狭窄に対するステント治療 | |
| 発刊年月 | 2000年 06月 | |
| 著者 | 山口 武人 | 千葉大学医学部第一内科 |
| 【 要旨 】 | 慢性膵炎では主膵管狭窄が高頻度にみられる.膵管の狭窄は上流膵管の内圧上昇と膵液流出を障害し,痔痛などの症状発現や膵機能障害を引き起こす．ステント治療は膵液のうっ滞を改善し,膵管内圧を軽減する目的で行われる.適応としては,(1)限局性の主膵管狭窄,(2)狭窄が乳頭側,(3)疼痛などの有症状,(4)膵機能が保たれている,である.また,膵炎発作を繰り返す例や膵管と交通のある仮性嚢胞,膵石治療後の再発予防も適応と考えられる.自験例では25例に対し総計49回のステント治療を行った.その結果,疼痛の消失はほぼ100%であり,またステントを持続的に留置することにより再発も予防できることが明らかとなった.今後は膵機能に対する有効性を検討する予定である. | |
| Theme | Endoscopic Stenting for Digestive Diseases | |
|---|---|---|
| Title | Endoscopic Stenting in Severe Main Pancreatic Duct Stenosis with Chronic Pancreatitis | |
| Author | Taketo Yamaguchi | First Department of Medicine, Chiba University School of Medicine |
| [ Summary ] | Stenosis of the main pancreatic duct (MPD) is frequently associated with chronic pancreatitis. The increase of MPD pressure or stasis of pancreatic juice is caused by stenosis associated with MPD. This is also a cause of pain as well as decreased pancreatic functioning. Endoscopic pancreatic stenting is mainly aimed at pain relief in this situation. Good indications for endoscopic stenting in chronic pancreatitis are as follows : 1) short stenosis associated with MPD, 2)stenosis located in the pancreatic head, 3)painful symptoms, and 4)to preserve pancreatic functioning. Recurrence of pancreatitis, pseudocysts associated with MPD, or prevention of pancreatic stone formation after successful stone extraction is thought to be the second line indication for endoscopic stenting. We have performed endoscopic stenting in 25 patients with severe stenosis associated with MPD, for a total of 49 procedures. Nearly 100% pain relief has been achieved with endoscopic stenting. In addition, permanent stenting appeared to be effective in the prevention of recurrence of pain. In the future, we hope to assess the efficacy of endoscopic stenting for preservation of pancreatic functioning. | |