Endoscopic Placement Of Pancreatic Duct Stent Through Minor Duodenal Papilla In The Treatment Of Acute Pancreatitis

Objective :To investigate the feasibility,safety,efficacy and short-term outcome of endoscopic placement of pancreatic duct stent through minor duodenal papilla for acute pancreatitis.Methods :Through an observational study,patients admitted to our hospital from September 2018 to June 2020 due to acute pancreatitis and drainage of pancreatic duct stent placed through the minor duodenal papilla were selected as the research objects.Collect patients’ general information,recovery through the mouth to eat(tolerance through the mouth to eat and no abdominal pain,nausea after eating again)time,length of hospital stay,and preoperative and postoperative 24 h hour white blood cells,serum amylase,serum lipase,APACHE II score,mortality and incidence of pancreatitis related complications,endoscopic surgery related complications,need because of the complication of acute pancreatitis other measures for surgical intervention rate,hospitalization costs,follow-up of recurrent acute pancreatitis,etc.SPSS 22.0 software was used for preservation and analysis to evaluate the therapeutic effect.Results : In 18 patients(12 men and 6 women),16 patients were successfully treated and discharged through minor duodenal papilla pancreatic duct stent drainage.At the same time,the main pancreatic duct placed a shorter stent,play a double pancreatic duct stent drainage role.No patient died,If no patient is transferred ICU strengthened,No endoscopic surgery related complications occurred.Of these,2 patients(11.11%)underwent abdominal puncture and drainage surgery for local complications,In 15 cases(83.33%),oral feeding resumed within 3 days,The blood white blood cell count,APACHE II score,serum amylase and lipase decreased significantly after 24 h,The median length of stay was 5(3.75-9)days,The median hospitalization cost was 25123.82(22942.50-43874.68)RMB.Follow-up was 9-29 months long,Five patients recurred during follow-up(4 patients recurred after pancreatic duct stent removal,Recurrence in 1 patients with pancreatic duct stents,The recurrence rate was 27.78.Conclusion : For patients with acute pancreatitis complicated by pancreatic fission and pancreatic duct deformity,early endoscopic drainage of the pancreatic duct stent via the minor duodenal papilla has a certain therapeutic effect,which is worthy of clinical promotion;In addition,for patients who cannot be identified by routine examination and who have recurrent pancreatitis,the etiology such as Pancreas divisum should be further excluded.