儿童慢性胰腺炎的手术治疗

A. Kislenko, A. Razumovsky, V. V. Kholostova, Z. B. Mitupov, A. Zadvernyuk, G. Y. Chumakova
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引用次数: 0

摘要

儿童慢性胰腺炎是一种持续性或反复发作的疾病,其特点是胰腺(PG)发生不可逆转的炎症和破坏性变化、进行性纤维化,并伴随着胰腺外分泌和内分泌功能的逐渐减退。近几十年来,胰腺癌患者显著增加;儿童发病率估计为每 10 万人中有 2 例。文献显示,儿童慢性胰腺炎结果中胰腺癌的发生率为 6.2%。CP 的死亡率在不同的研究中有所不同:15-20% 的 CP 儿童死于并发症和继发性疾病。本研究的目的是在回顾现代文献的基础上,研究当前存在的问题,并确定儿童慢性胰腺炎的治疗前景。材料和方法。作为准备工作的一部分,对世界和国内有关儿童慢性胰腺炎外科治疗的文献进行了系统回顾。结果。文献检索证实,在儿童慢性胰腺炎的外科治疗方面缺乏共识。由于观察资料较少,我们无法对儿童 CP 手术治疗的长期效果进行分析。遗传性胰腺炎患者是一个特殊的挑战;文献中没有关于这类患者治疗方法的描述。此外,文献中也仅有关于儿童胰腺炎并发症的个别描述;关于手术治疗儿童内分泌和外分泌功能不全的有效性,也没有可靠的结果。有必要开展科学和实用的研究,以制定 CP 儿童手术治疗的适应症,并验证具体的并发症。
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Surgical treatment of chronic pancreatitis in children
Chronic pancreatitis in children is a continuous or recurrent disease characterized by irreversible inflammatory and destructive changes in the pancreas (PG), progressive fibrosis, accompanied by a gradual decrease in its exocrine and endocrine functions. In recent decades, there has been a significant increase in patients with CP; the incidence in children is estimated at 2 cases per 100,000 people. According to the literature, pancreatic cancer in the outcome of chronic pancreatitis in childhood is 6.2%. Mortality rates for CP vary in different studies: 15-20% of children with CP die from complications and secondary disorders. The purpose of the study is to study current problems and determine the prospects for the treatment of chronic pancreatitis in children based on a review of modern literature. Materials and methods. As part of the preparation, a systematic review of the world and domestic literature on the surgical treatment of chronic pancreatitis in children was carried out. Results. A literature search confirmed the lack of consensus regarding the surgical treatment of CP in children. The small number of observations does not allow us to analyze the long-term results of surgical treatment of children with CP. Patients with hereditary pancreatitis pose a particular challenge; treatment algorithms for this group of patients are not described in the literature. Also in the literature there are isolated descriptions of complications with CP in children; there are no reliable results of the effectiveness of surgical intervention for endocrine and exocrine insufficiency in children. It is necessary to conduct scientific and practical research to develop indications for surgical treatment of children with CP and to verify specific complications.
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