Résumé
To evaluate the possible method for the diagnosis and treatment of chronic pancreatitis (CP), two hundred and sixty two cases of CP from January 1993 to May 2001 were involved and analyzed retrospectively. Etiologic factors in this group included 68 3% of biliary disorders, 21 4% of alcoholic intake, 29 8% of acute pancreatitis (AP) episode history, and 13% of pancreatic divisum (PD). The major symptom of CP was discomfort or pain over the upper abdominal. Ultrasonography, CT, MRCP, ERCP, and EUS were useful for the diagnosis of CP. One hundred and thirty two patients were treated conservatively, and 78 patients were treated with endoscopy, while only 52 patients were treated with operation. The short term remission rates of symptoms were satisfactory in all cases, and long term ones in 238 patients. Biliary disorders were the most common etiology for CP in this group.The results suggest that the clinical symptoms of CP are not specific and choices of image tools for diagnosis of CP are important. Medication can be used in mild CP patients, but in patients ac companied with sever complications and stubborn abdominal pain surgical operation should be carried out. Furthermore, endoscopy is a useful tool not only for the diagnosis of CP but also for its treatment.
Résumé
The aim of this study was to evaluate the diagnostic value of MRCP and ERCP in patients with chronic pancreatitis. A total of 262 patients were diagnosed as charonic pancreatitis by clinical feature, screenage and pathology from January 1993 to December 2001 in Changhai Hospital. Among them 120 patients who had been subjected to MRCP and ERCP were analyzed retrospectively. There were 106 patients discovered constriction, dilatation and calculuses of pancreatic, bile ducts, and diagnosed chronic pancreatitis by MRCP, the sensitivity was 88 3%. Also there were 108 patients discovered cholangiopancreatic disorder and diagnosed chronic pancreatitis by ERCP, the sensitivity was 90%. No statistical difference was found between interpretations based upon MRCP and ERCP( P =0 678). Results from both MRCP and ERCP discovered 96 patients with chronic pancreatitis; the agreement rate in diagnosis was 81 4%. Furthermore, 118 patients were diagnosed chronic pancreaitis by MRCP or ERCP, and the sensitivity was up to 98 3%. In addition, all examined patients were succeeded and no severe complications were found in regard to examination itself. So MRCP is as sensitive as ERCP when detecting chronic pancreatitis. Furthermore, it is feasible to presume that all chronic pancreatitis cases could be diagnosed by MRCP combined with ERCP.